Endoscopic Presentations Of Primary Gastric Lymphoma

ObjectiveTo improve the diagnostic rate of primary gastric lymphoma by observing and analyzing its endoscopic features.MethodsWe performed a retrospective systematic collection of data from June2004to October2012in Qilu Hospital of Shandong University, identified37patients with primary gastric lymphoma diagnosed by pathology (endoscopy non-suspected group) and48patients with pseudo-diagnosed lymphoma by endoscopy(endoscopy suspected group) and analyzed the relevant endoscopic data. Data analysis was dealt with the SPSS11.5software.Results1.Both the endoscopy non-suspected group and the endoscopy suspected group mainly involved single part of the stomach and the most common location was the corpus gastricum.There was significant difference between the two groups in endoscopic location(.P<0.05).2. The macroscopic patterns of the two groups were categorized as:ulcerative type, tumor-like and polypoid type, nodular type and hypertrophic type. The endoscopy non-suspected group mainly present as ulcerative type(26/37,70.3%) and tumor-like and polypoid type(9/37,24.3%),however the endoscopy suspected group were mainly hypertrophic type(23/48,47.9%)and ulcerative type (15/48,31.3%).Obviously, there was significant difference between the two groups in endoscopic patterns (P<0.05).3.The lesions of both the endoscopy non-suspected group and the endoscopy suspected group had four kinds of texture. And there were respectively33paients and38paients whose endoscopic reports described texture. The texture of the endoscopy non-suspected group were soft(1/37,2.6%),crisp(13/37,35.2%),tenacious (6/37,16.2%) and stiff (13/37,35.2%);the endoscopy suspected group were soft (8/48,16.7%),crisp(12/48,25.0%),tenacious(5/48,10.4%)and stiff (13/48,27.1%).There was no significant difference between the two groups in endoscopic texture (P>0.05) as well as the endoscopic movements (P>0.05).4.The pathological patterns of the endoscopy non-suspected group were B cell type(36/37,97.3%) and T cell type(1/37,2.7%),and mainly was diffuse large B cell type (26/37,70.3%). The endoscopy suspected group had6patients with primary gastric lymphoma and the coincidence rate of endoscopy and the pathology was12.5%.ConclusionsEndoscopic manifestations of primary gastric lymphoma are variable. The most common location is the corpus gastricum and most common macroscopic pattern is ulcerative type. And the main type in pathology is diffuse large B-cell lymphoma(DLBCL). The diagnosis rate of PGL by endoscopy is low. It’s of vital significance to the diagnosis of PGL by combining deep and multi-site biopsy and endoscopic ultrasonography.