Clinical manifestations and endoscopic presentations of gastric lymphoma: a multicenter seven year retrospective survey
2017
Background and aim: To improve the diagnostic rate of
gastric lymphoma by analyzing clinical and endoscopic features of
patients with gastric lymphoma and suspected gastric lymphoma.
Methods: Clinical and endoscopic records of 35 patients with
gastric lymphoma (positive group) and 133 patients with suspected
gastric lymphoma but subsequent non-malignant pathology (negative
group) were analyzed retrospectively. Data from another 99 gastric
lymphoma patients with malignant pathology but nonspecific
endoscopy (endoscopy non-suspect group) were analyzed.
Results: Abdominal pain was the predominant symptom
reported in both the positive and negative lymphoma groups,
representing 60.0 and 52.5%, respectively. No significant
differences in age, sex and clinical manifestations in subjects
from the two groups were found. In the positive group, 54.3%
were ulcerative; 34.3%, infiltrative; 8.5%, polypoid; and 2.9%,
granulonodular. In the negative group, 52.6% were infiltrative;
42.1%, ulcerative; 4.5%, granulonodular; and 0.75%, polypoid.
The endoscopic results varied between the two groups (p < 0.05). In
the non-suspect group, 66.7% were ulcerative; 17.2%, infiltrative;
14.1%, polypoid; and 2.0%, granulonodular. With regards to
histology, diffuse large B cell lymphoma was the most common
subtype. The sensitivity of endoscopy was 60% for detecting
malignancy and 21% for gastric lymphoma.
Conclusion: The present study suggests that gastric lymphoma
and suspected gastric lymphoma have similar clinical features.
Gastric lymphoma presented mainly as macroscopic ulcerative
lesions, whereas suspected gastric lymphoma appeared mainly as
infiltrative lesions. Although the diagnostic rate of gastric lymphoma
was relatively low (21%), it can be identified by endoscopy (60%).
To improve diagnosis, repetitive endoscopic biopsies should be
performed and novel endoscopic techniques developed in the future.
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