Lymphoma mimic often misdiagnosed as cancer

September 26, 2013 | by

Nearly 70,000 new cases of non-Hodgkin lymphoma are diagnosed each year. But new research suggests another disease may be wrongfully included among those cases.

In a study recently published in Blood, an international team of pathologists uncovered what they believe to be a unique disease that mimics a type of aggressive lymphoma found in the gut. The researchers dubbed the syndrome “indolent T-cell lymphoproliferative disease of the gastrointestinal tract,” or indolent T-LPD.

Image of diseased intestine

City of Hope researchers described a new gastrointestinal disease that mimics lymphoma. The findings could save patients from unnecessary and harmful anti-cancer treatments. Image credit: Blood journal

The disease does not appear to be deadly, nor does it respond to treatments designed for lymphoma.

“It’s probably a non-neoplastic reactive condition but it would be easily mistaken for lymphoma,” said Dennis Weisenburger, M.D., chair and professor of the Department of Pathology at City of Hope and a co-author on the study.

Indolent T-LPD has symptoms very similar to primary T-cell lymphoma of the gastrointestinal tract and enteropathy-associated T-cell lymphoma. These cancers arise when immune system T cells turn malignant and infiltrate the intestine, colon, stomach or esophagus. These lymphoma types are difficult to treat and have poor outcomes, with less than one in five patients surviving five years.

Weisenburger, who collaborated on the study with colleagues from 12 institutions in five countries, said indolent T-LPD also might appear as inflammatory bowel disease.

“Some clinicians might mistakenly treat [indolent T-LPD] as they would Crohn’s disease or ulcerative colitis,” he said. “But this is a new entity that hasn’t previously been described. Ours is the first paper to really look at it and provide a better diagnosis.”

The researchers were tipped off to the possibility of a novel disease when they saw a case that ran on for an unusually long period but never responded to chemotherapy. So they searched for, found and studied 10 similar cases of unusual lymphoma-like gastrointestinal disease, gathering information from cases diagnosed in the U.S., Canada, the United Kingdom, France and Norway.

Weisenburger said he hopes the findings will alert pathologists to look for this rare condition when diagnosing lymphomas involving the gastrointestinal tract, so patients can get the right treatment for their symptoms and avoid the harsh anticancer treatments that won’t help anyway.