Primary extranodal lymphomas of stomach: clinical presentation, diagnostic pitfalls and management

Second Department of Internal Medicine Propaedeutic, Athens University Medical School, University General Hospital Attikon, Haidari, Greece.
Annals of Oncology (Impact Factor: 6.58). 12/2008; 19(12):1992-9. DOI: 10.1093/annonc/mdn525
Source: PubMed

ABSTRACT Gastrointestinal lymphoma is the most common form of extranodal lymphoma, accounting for 30%–40% of cases. The most commonly
involved site is the stomach (60%–75% of cases), followed by the small bowel, ileum, cecum, colon and rectum. The most common
histological subtypes are diffuse large B-cell lymphoma (DLBCL) and marginal zone B-cell lymphoma of the mucosa-associated
lymphoid tissue (MALT). Helicobacter pylori infection has been implicated in the pathogenesis of MALT gastric lymphoma, but its role in gastric diffuse large B-cell
non-Hodgkin's lymphoma (NHL) is controversial. The therapeutic approach for patients with gastric NHL has been revised over
the last 10 years. Conservative treatment with anthracycline-based chemotherapy alone or in combination with involved-field
radiotherapy has replaced gastrectomy as standard therapy in cases with DLBCL. Additionally, MALT lymphomas are mainly treated
with antibiotics alone, which can induce lasting remissions in those cases associated with H. pylori infection. Nevertheless, various therapeutic aspects for primary gastric lymphomas are still controversial and several questions
remain unanswered. Among others, the role of rituximab, consolidation radiotherapy as well as H. pylori eradication in histological aggressive subtypes warrants better clarification.

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Available from: Sotirios Papageorgiou, Jul 04, 2015
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