Lymphoma- large-cell
Overview
A very rare form of malignant stomach cancer involving lymph tissue.
Symptoms
* Abdominal mass * Abdominal pain * Anemia * Abdominal bleeding * Stomach perforation * Abdominal obstruction * Abdominal mass
Diagnosis
* Common (featuring a predominance of hallmark cells) * Small cell (featuring smaller cells with the same immunophenotype as the hallmark cells) * Lymphohistiocytic * Sarcomatoid * Signet ring
Prognosis
During treatment, relapses may occur but these typically remain sensitive to chemotherapy. Those with ALK positivity have a better prognosis. It is possible that ALK-negative anaplastic large cell lymphomas represent other T-cell lymphomas that are morphologic mimics of ALCL in a final common pathway of disease progression. It is possible that existing systems of classification will be revised in the future to exclude such lymphomas from this specific diagnosis.
Treatment
* Managed under "Aggressive Lymphoma" guidelines o CHOP is first line of treatment, CHOP-Rituxan in the unlikely scenario that CD20 is positive, given that CD20 is a B-cell marker. o Radiation therapy as per institutional preference (based on ECOG, SWOG, and GELA trials), but usually added for bulky disease * Overall better prognosis than other "Aggressive Lymphomas" o ALK+ 5-year survival 70-80% o ALK- 5-year survival 30-50%