[Diagnosis and therapeutic management of gastric lymphomas].
OBJECTIVE
The optimal management of primary gastric non-Hodgkin's lymphoma (PGL) remains controversial. The purpose of this paper is to describe the histopathology, clinical behavior and management of 15 patients with PGL.


METHODS
All patients were diagnosed of PGL in our Center from January 1985 to September 1995. Resection specimens were reexamined and cases were reclassified according to the concept of MALT-derived lymphoma. Age, sex, symptoms, localization, stage, treatment, complications and response were reported.


RESULTS
9 patients had low-grade B-cell lymphoma of MALT type, 5 had high-grade B-cell lymphoma (one with evidence of low-grade lymphoma of MALT type) and 1 had centroblastic-centrocytic B-cell lymphoma. Seven cases were diagnosed by endoscopy biopsies, 8 through laparatomy specimens. Stage was I in 3 cases, II1 in 5, II2 in 5, III in 0 and IV in 2. 13 patients had undergone primary gastric resection: 10 received additional chemotherapy and 1 radiotherapy. The two cases with stage IV have died: one died after surgery and one relapsed immediately after chemotherapy. After a median follow-up of 40 months, 13 patients are alive: 11 in complete response and 2 in relapse. Minor surgical complications occurred in 12 patients and major complications in 6 patients.


CONCLUSIONS
Gastric resection still plays an important role in the management of early-stage PGL. Chemotherapy can be an effective therapeutic procedure in unresected or surgical high-risk patients.
Grau
E
E
Servicio de Hematología y Hemoterapia, Hospital Lluís Alcanyís, Xàtiva, Valencia.
Perella
M
M
Gómez
A
A
Pastor
E
E
Mirabet
M D
MD
García
F
F
Ibáñez
J L
JL
Aguiló
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage; D011867:Radioisotope Teletherapy; D012074:Remission Induction; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage; D014751:Vindesine / Q000008:administration & dosage
D016685:Mitomycin; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D014751:Vindesine; D011241:Prednisone
Diagnóstico y manejo terapéutico de los linfomas gástricos.