CT findings are highly predictive for perforation in patients with diffuse large B-cell lymphoma involving the intestines

Leuk Lymphoma. 2018 Aug;59(8):1878-1883. doi: 10.1080/10428194.2017.1403023. Epub 2017 Nov 27.

Abstract

Patients with diffuse large B-cell lymphoma (DLBCL) presenting with intestinal involvement are prone to develop perforation. Identification of those who are at high risk for this complication would enable a rational-based decision regarding preemptive surgery. Although computed tomography (CT) is widely used at diagnosis, data regarding its ability to predict intestinal perforation are scanty. We performed a retrospective single-center study, including all consecutive DLBCL patients presented with intestinal involvement, assessing predictors for perforation with an emphasis on CT-related parameters. Forty-nine patients were included, 43 (88%) underwent CT scan at diagnosis. Ten patients (20%) developed intestinal perforation. A univariate regression analysis found increased risk among patients with a concentric, transmural lesion, and a longer involved intestinal segment. In conclusion, CT scan results can define patients with DLBCL and intestinal involvement who are at risk for perforation, suggesting that a preemptive surgical resection should be considered in these cases.

Keywords: Lymphoma and Hodgkin disease; chemotherapeutic approaches; prognostication.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Intestinal Perforation / complications
  • Intestinal Perforation / diagnostic imaging*
  • Intestines / diagnostic imaging*
  • Intestines / pathology
  • Lymphoma, Large B-Cell, Diffuse / complications*
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis
  • Tomography, X-Ray Computed / methods*