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Endoscopic Findings of Gastric MALT Lymphoma Taiji Akamatsu 1 , Kei Kitahara 2 , Haruaki Shirakawa 2 , Shinya Ichikawa 2 , Tadanobu Nagaya 2 , Takamori Sudo 2 , Ryutarou Takeda 2 , Kazuhiro Takenaka 2 , Hiroyoshi Ota 3 , Hideharu Miyabayashi 4 , Eiji Tanaka 2 1Department of Endoscopy, Shinshu University Hospital, Matsumoto, Japan 2Department of Internal Medicine, Gastroenteroミlogy, Shinshu University School of Medicine, Matsumoto, Japan 3Department of Biomedical Sciences, School of Health Sciences, Shinshu University School of Medicine, Matsumoto, Japan 4Internal Medicine, National Hospital Organization, Matsumoto Hospital, Matsumoto, Japan Keyword: 胃MALTリンパ腫 , 内視鏡所見 , 鑑別診断 , 早期胃癌 , 胃炎 pp.805-812
Published Date 2009/4/25
DOI https://doi.org/10.11477/mf.1403101659
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 To elucidate the difference in endoscopic findings of gastric MALT lymphoma(GML)and early gastric cancer(or gastritis), we studied 98 cases of GML. Endoscopic findings of all cases were recognized as superficial type according to Sano's classification. Further, these endoscopic findings could be classified into 3 types ; early gastric cancer(type IIc)-like type(EGC type)GML, gastritis-like type(GI type), and protruded type(PT type). Forty-three of 98 cases were classified into EGC type GML, and another 49 cases were GI type. The remaining 6 cases were divided into PT type GML. EGC type GML often looked like IIc type early gastric cancer, but features of endoscopic findings of EGC type GML were as follows ; 1)unclearness of the peripheral margin, 2)lack of moth-eaten appearance, 3)existence of superficial fine pattern, 4)multiple lesions. Endoscopic findings of GI type GML could be subclassified into erosive/ulcer type, change-of-hue type, and granular/nodular type. GI type GML was easily misdiagnosed as erosive gastritis, gastric ulcer, chronic atrophic gastritis, or follicular gastritis because of the similarity of the endoscopic finding. PT type GML should be distinguished from submucosal tumor such as gastrointestinal stromal tumor and IIa type early gastric cancer. No significant difference was recognized between EGC type and GI type GML according to sex, age, affected region, and stage. On the other hand, depth of invasion was significantly limited to within the mucosa in GI type GML compared with EGC type(P<0.01), and the positive rate of Helicobacter pylori infection in GI type GML was higher than that in EGC type(P<0.01).


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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