Clinical and Pathological Features in 32 Cases with Low-grade Gastric Lymphoma of Mucosa-associated Lymphoid Tissue Hiroshi Suekane 1 , Mitsuo Iida 1 1The Second Department of Internal Medicine, Faculty of Medicine, Kyushu University Keyword: 胃原発性悪性リンパ腫 , 胃MALTリンパ腫 , 胃RLH , X線・内視鏡検査 , 超音波内視鏡検査 pp.1039-1051
Published Date 1993/9/25
DOI https://doi.org/10.11477/mf.1403106259
  • Abstract
  • Look Inside
  • Cited by

 To determine the clinical and pathological features of low-grade gastric lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), 32 surgical cases were studied. Of 20 cases which were operated on during the period from 1965 to 1987, 17 had been initially diagnosed as reactive lymphoreticular hyperplasia (RLH), and 2 as malignant lymphoma (ML) combined with RLH. Twelve cases which were operated on during the period from 1988 to 1993 had been initially diagnosed as malignant lymphoma. In 5 cases with early MALT lymphomas, conventional endoscopic forceps biopsy did not provided a definite histologic diagnosis, so endoscopic mucosal resection was performed to obtain specimens large enough to include the submucosa.

 All 32 cases were divided according to the depth of the tumor into two groups: early stage group (22 cases) and advanced stage group (12 cases). Clinical and pathological features in these two groups were compared. As a result, there was a female predominance in the early stage group, and the duration of the disease was relatively longer in the advanced stage group. Radiography and endoscopy frequently demonstrated various findings such as diffuse granular mucosa, multiple erosions and ulcers, and depressed lesion simulating Ⅱc-type early gastric cancer in both groups. Endoscopic ultrasonography revealed two characteristic patterns: “superficially spreading type” in the early stage group, and “diffusely infiltrating type” in the advanced stage group. In 2 cases, histologic evaluation showed high-grade lymphoma combined with MALT lymphoma. Para-gastric lymph node involvement was evident in 3 patients of the advanced stage group.

 It is suggested that MALT lymphoma shows slow infiltrative growth and remains confined to the stomach for long periods of time. In some cases, however, transmural infiltration and spread beyond para-gastric lymph nodes may occur during the long-term follow-up period. Therefore, MALT lymphoma should be clinically treated as low-grade malignancy. The early diagnosis of this disease is essential for better prognosis.

Copyright © 1993, Igaku-Shoin Ltd. All rights reserved.


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