Abstract:

INTRODUCTION: The gastrointestinal tract is the most common extranodal region for hematolymphoid neoplasms. However, when compared to inflammatory lesions or epithelial tumors, this group of neoplasms is quite rare and some of them cause diagnostic difficulties. In this study, the clinicopathological features of common hematolymphoid neoplasms of the gastrointestinal tract were aimed to be represented and observed rare entities were highlighted. METHODS: Forty-six patients who were diagnosed of hematolymphoid neoplasia with gastrointestinal system infiltration between the years 2014 and 2021 were selected retrospectively from the archives of pathology department. Pathology reports, demographic and clinical data, endoscopic and imaging findings were collected from the hospital information system. RESULTS: Thirty-six of the patients were diagnosed of primary neoplasms of the gastrointestinal tract. Nine patients were accepted as secondary spread of systemic disease to the gastrointestinal tract. For one patient, differential diagnosis regarding primary or secondary disease could not be made with available data. The mean age was 56. Approximately three-quarters (73.9%) of the cases were diagnosed by endoscopic biopsy. Patients frequently (73.9%) presented with nonspecific gastrointestinal symptoms. However, ileus was described in cases with bowel localization. The most common diagnosis was diffuse large B-cell lymphoma (n: 26) followed by MALT lymphoma (n: 6). We had four patients diagnosed as duodenal-type follicular lymphoma. Rare cases were IRF4-associated large B-cell lymphoma (n: 1), EBV positive large B cell lymphoma (n: 1), extracavitary/solid variant primary effusion lymphoma (n: 1), myeloid sarcoma (n: 1). DISCUSSION AND CONCLUSION: An unexpected difference was that the number of patients with diffuse large B-cell lymphoma was more than four times of MALT lymphoma. Possibility of confusion with poorly differentiated carcinomas is an important handicap especially in rare high grade lymphomas and myeloid neoplasms. Duodenal lymphoid follicles should be carefully evaluated and immunohistochemical evaluation should be performed.

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