Lymphomas With Primary Gastrointestinal Presentation: A Retrospective Study Covering a Five-Year Period at a Quaternary Care Center in Southern India.

Background and objective Lymphomas can involve the gastrointestinal (GI) tract as a primary disease or as a secondary spread of systemic disease. The GI tract is a key site for extranodal lymphomas, with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) occurring in this region. This study aimed to analyze the demography, anatomic distribution, histological subtypes, and immunomorphological characteristics of all lymphomas with a primary GI presentation at a quaternary care hospital in southern India. Methods We conducted a retrospective study covering the period from 2018 to 2022 involving all cases of lymphomas with primary GI presentation. All the cases were categorized based on morphological and immunophenotypic criteria per the World Health Organization (WHO) 2022 classification of hematopoietic and lymphoid neoplasms. Data were analyzed by using the statistical software SPSS Statistics version 28.0 (IBM Corp., Armonk, NY). Results Out of 2,455 lymphoma cases diagnosed in the five-year study period, 156 presented with primary GI symptoms. Males constituted 113 (72.5%) cases and 43 (27.5%) patients were females. The stomach (n=81; 52%) was the most common site, followed by the small intestine (n=40; 27%), large intestine (n=33; 20%), and esophagus (n=2; 1%). Most lymphomas involving the GI tract were NHL (n=152; 97%), and the remaining included four (3%) cases of HL. Diffuse large B-cell lymphoma (DLBCL) was the most frequent (n=102; 65.3%) B-cell NHL. Eight cases of T-cell lymphomas were noted including rare entities. Conclusions This study is one of the largest of its kind involving lymphomas with primary GI presentation from India. The distribution and incidence of various entities in our study were comparable to various other studies from India and those from Western countries. GI lymphomas are heterogeneous, with distinct prognoses and treatment strategies. Hence, diagnosing them correctly would help in prognostication and providing prompt therapy.