Sa1261 DIFFERENCES IN ENDOSCOPIC FINDINGS BETWEEN PRIMARY AND SECONDARY GASTRIC LYMPHOMA

Abstract

Gastric lymphoma occupies about 5% of gastric malignancy and diffuse large B cell lymphoma (DLBCL) is most common type of primary gastric lymphoma. Since endoscopic findings of gastric lymphoma are ambiguous and diverse, it is not easy to distinguish from gastric adenocarcinoma. Moreover, it is more difficult to distinguish between primary gastric lymphoma and gastric involvement of lymphoma. The aim of this study was to investigate the clinical and endoscopic features and differences of primary gastric lymphoma and gastric involvement of lymphoma. Forty-eight patients were enrolled in this retrospective study between June 2008 and February 2017. These enrolled patients were divided into primary gastric lymphoma group (primary group, n=18) and gastric involvement group (secondary group, n=30) based on whether or not they had only gastric lesion. Patient’s clinical characteristics, endoscopic findings and pathologic data were retrospectively reviewed by using electronic medical record. The mean age of the whole patients was 63.31±13.12 years and twenty-nine patients were female (60.4%). When considering all patients, DLBCL on pathology (81.3%), gastric body involvement on location (47.9%) and ulceroinfitrative morphologic type on endoscopy (43.8%) were more common features. Regardless of the two groups, only about 41.7% of the initial endoscopic diagnosis considered lymphoma. Compared to primary group, regional lymph node involvement (p<0.001) and bone marrow involvement (p=0.072) were more associated with secondary group. However, there was no significant findings on endoscopic features including location, size, number and morphology of lesion. Endoscopically diagnosis of gastric lymphoma is not easy, even when confirmed separately for the primary and secondary groups, there is no endoscopic difference. Therefore, in order to diagnose the gastric lymphoma, aggressive tissue examination is important.