Clinical and endoscopic presentation of primary gastric lymphoma: a multicentre study

• Published in: Alimentary pharmacology & therapeutics Vol. 23; no. 6; pp. 721 - 726
• Main Authors: ANDRIANI, A., ZULLO, A., DI RAIMONDO, F., PATTI, C., TEDESCHI, L., RECINE, U., CARUSO, L., BONANNO, G., CHIARENZA, A., LIZZANI, G., MIEDICO, A., ROMANELLI, A., COSTA, A., LINEA, C., MARRONE, C., MIRTO, S., MISTRETTA, A., MONTALBANO, L., RESTIVO, G., VINCI, M., BIBAS, M., HASSAN, C., STELLA, F., COTTONE, M., MORINI, S.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.03.2006; Blackwell
• Subjects: Biological and medical sciences; Digestive system; Endoscopy, Gastrointestinal - methods; Female; Gastric Mucosa - pathology; Gastroenterology. Liver. Pancreas. Abdomen; Helicobacter Infections - complications; Helicobacter Infections - pathology; Helicobacter pylori; Helicobacter pylori - isolation & purification; Hematologic and hematopoietic diseases; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma - complications; Lymphoma - microbiology; Lymphoma - pathology; Male; Medical sciences; Middle Aged; Neoplasm Staging; Pharmacology. Drug treatments; Retrospective Studies; Stomach - pathology; Stomach Neoplasms - complications; Stomach Neoplasms - microbiology; Stomach Neoplasms - pathology; Stomach; Symptomatology; Digestive system; Lymphoproliferative syndrome; Multicenter study; Primary; Malignant hemopathy; Endoscopy; Lymphoma
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2006.02826.x

Summary Background Although the stomach is the most frequent site of intestinal lymphomas, few data are available on both clinical endoscopic presentation of gastric lymphoma and possible differences between low‐grade and high‐grade lymphomas. Methods Clinical, histological and endoscopic records of consecutive patients with primary low‐grade or high‐grade lymphoma diagnosed were retrieved. Symptoms were categorized as ‘alarm’ or ‘not alarm’. The endoscopic findings were classified as ‘normal’ or ‘abnormal’. Results Overall, 144 patients with primary gastric lymphoma were detected, including 74 low‐grade and 70 high‐grade lymphoma. Alarm symptoms, particularly persistent vomiting and weight loss, were more frequently present in patients with high‐grade lymphoma than in those with low‐grade lymphoma (54% vs. 28%; P = 0.002). Low‐grade lymphomas presented as ‘normal’ appearing mucosa (20% vs. 0%; P = 0.0004) or petechial haemorrhage in the fundus (9% vs. 0%; P = 0.02) more frequently than high‐grade lymphomas, being also more often confined to the antrum (47% vs. 27%, P = 0.03) and associated with Helicobacter pylori infection (88% vs. 52%, P < 0.0001). On the contrary, high‐grade lymphomas presented more commonly as ulcerative type (70% vs. 52%; P = 0.03), being also more frequently diagnosed in stage >I when compared with low‐grade lymphomas (70% vs. 21%, P < 0.0001). Conclusions The overall prevalence of alarm symptoms is quite low and may be absent in more than 70% of patients with low‐grade lymphoma.