Lymphomas of the gastrointestinal tract.

Lymphomas occurring primarily in the alimentary tract present in the same way as carcinomas. Because they have a much better prognosis than carcinoma, especially in the case of gastrict lymphomas, it is important that they be diagnosed. For this reason, laparotomy if necessary should be undertaken in order to establish a histologic diagnosis of all alimentary neoplasms. With modern equipment, however, it is often possible to obtain enough tissue for diagnosis by endoscopic means. The ideal treatment is surgery, but if there is doubt about the completeness of excision or if there are involved lymphnodes, postoperative radiotherapy is desirable. The types of primary alimentary lymphoma are similar to those occurring in lymphnodes, and they may be follicular (nodular) or diffuse. Hodgkin's disease is less common than the other lymphomas and has a somewhat worse prognosis. The main prognostic features of alimentary lymphomas are type of lymphoma and degree of differentiation. Follicular lymphomas have a better prognosis than diffuse lymphomas and well differentiated lymphocytic lesions have a better prognosis than large cell poorly differentiated tumors. Lymphnode involvement has no significance in the overall survival rates.