The Comparison of Clinical Findings and Endoscopic Patterns between Primary Gastric MALToma and Diffuse Large B-Cell Lymphoma: One Center Experience

Abstract

Background: The remission rate and long-term survival duration in gastric lymphoma patients depend on the disease stage and histological type at diagnosis. However, the disease remains challenging for the clinician and endoscopist because of its nonspecific clinical presentation and endoscopic patterns. The particular characteristics that distinguish primary gastric MALToma from diffuse large B-cell lymphomas (DLBCL) need more investigation.Methods: We retrospectively reviewed the records of primary gastric lymphoma patients between January 2003 and September 2011. Data analyzed included age, sex, symptoms, Lugano staging, and laboratory data including complete blood cell count, platelet, blood sugar, serum albumin, serum lipid, LDH levels and liver function. Endoscopic findings including gross appearance, mean lesion size, gastric site involved, need for repeat biopsy, H. pylori infection, and histology were recorded.Results: Thirty primary gastric lymphoma patients including 20 with DLBCL were observed. The incidences for men and women were nearly equal, and the mean patient age was 62.1 years. Overall, 20 (66.7%) patients complained of alarm symptoms at diagnosis, and the Lugano staging of 17 (60.7%) was Stage I. Most endoscopic lesions were ulcers, including ulcerative type and exophytic type with surface ulceration (93.6%), with 60% involving the gastric body. The mean lesion size differed significantly between gastric DLBCL and MALToma (4.2 ± 2.6 vs. 2.2 ± 2.1, p ＜ 0.05) and the overall rate of unsuccessful first endoscopic biopsy was high (20%).Conclusions: Ulcerative-type presentation in gastric lymphomas represented more than 90% of cases and the mean lesion size differed significantly between gastric DLBCL and MALToma.