Primary Gastric Non-Hodgkin's Lymphoma: A Retrospective Clinicopathologic Study Of 41 Cases

Background and aimGastric lymphoma includes both primary gastric lymphoma and systemic lymphoma with secondary gastric involvement. Lymphoma is the second most common gastric malignancy after gastric adenocarcinoma. In the United States, it represents about 5% of all gastric malignancies, with an annual incidence of less than 1 per 100,000 persons. More than 95% of gastric lymphomas are non-Hodgkin's lymphoma, cases of Hodgkin disease are rare. More than 90% of gastric lymphomas are of B cell origin, fewer than 8% are of T cell origin. Like gastric adenocacinoma, early stage gastric lymphomas are often clinically silent. But when gastric lymphomas are diagnosed at an advanced stage, the signs and symptoms are similar to those of advanced gastric cancer. Abdominal pain, gastrointestinal blood loss, abdominal mass, weight loss and anorexia are found in more than 25% of patients. The incidence of primary gastric non-Hodgkin's lymphoma (NHL) appears to have increased worldwide in recent years. The aim of this studywas to evaluate the clinical manifestation, gastrointestinal endoscopy and define histological feature of operative specimens in primary gastric non-Hodgkin's lymphoma (PG-NHL).MethodsThe data of all 41 patients over the recent 10 years (1991-2003) in the series with PG-NHL were retrospectively reviewed. Patients were eligible if they had biopsy-confirmed diagnosis obtained by endoscopy or following operation. Clinical and endoscopic features were analyzed, and histologic examination was determined.ResultsThe analysis of various clinical symptoms revealed abdominal pain, loss of body weight, fever, anorexia, abdominal tumor, nausea, vomiting and bleeding of upper digestive tract were most common. The occurrence of tumor localization in the body of stomach was 48.78%(20/41), gastric antrum 36.59%(15/41) and multiple localization was 14.63%(6/41). By means of immunohistochemistry, 35 patients (85.36%) had B-cell lymphoma, 5 (12.20%) had T-cell lymphoma and 1 (2.44%) had centroblastic-centrocytic T-cell lymphoma.ConclusionsAbdominal pain, weight loss, fever, anorexia, and bleeding of upper digestive tract were the predominant symptoms. PG-NHL mostly affected the body of stomach. Primary gastric B-cell non-Hodgkin's lymphoma was most common, however, primary gastric T-cell non-Hodgkin's lymphoma was not infrequent from histological findings. B ultrasonic and computerized tomography (CT) scanning proved to be the useful adjuncts in diagnosis andstaging of gastric lymphomas.