Gastric mucosa-associated lymphoid tissue lymphoma: radiographic findings in six patients.
OBJECTIVE
To determine the radiographic findings of low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma on double-contrast upper gastrointestinal studies.


METHODS
Pathology records, double-contrast upper gastrointestinal studies, and medical records of six patients with gastric MALT lymphoma were retrospectively reviewed.


RESULTS
The most common clinical findings at presentation included epigastric pain (n = 6), dyspepsia (n = 4), and nausea and vomiting (n = 4). Double-contrast studies revealed rounded, often confluent nodules of varying size in four patients with low-grade MALT lymphoma. Nodularity was located in the gastric antrum (n = 2), body (n = 1), or body and fundus (n = 1). A fifth patient had a malignant-appearing 1-cm-diameter antral ulcer, and a sixth had a 10-cm-diameter polypoid, ulcerated mass in the gastric fundus. The latter patient was found to have high-grade MALT lymphoma with low-grade MALT lymphoma abutting the tumor. Five patients had associated Helicobacter pylori gastritis. Five patients had stage I disease, and one had stage IIB disease. At endoscopic follow-up (n = 4), marked regression of tumor occurred after treatment with antibiotics, chemotherapy, and/or radiation therapy.


CONCLUSIONS
When low-grade MALT lymphoma is suspected on the basis of barium study results, endoscopic biopsy specimens should be obtained for a definitive diagnosis so these patients can be treated before the development of high-grade gastric lymphoma.
Yoo
C C
CC
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
Levine
M S
MS
Furth
E E
EE
Salhany
K E
KE
Rubesin
S E
SE
Laufer
I
I
Herlinger
H
H
D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003287:Contrast Media / Q000008:administration & dosage; D004415:Dyspepsia / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005748:Gastric Fundus / Q000000981:diagnostic imaging; D005753:Gastric Mucosa / Q000000981:diagnostic imaging* / Q000473:pathology; D005756:Gastritis / Q000382:microbiology / Q000473:pathology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000503:physiopathology; D009367:Neoplasm Staging; D010146:Pain / Q000503:physiopathology; D011127:Polyps / Q000000981:diagnostic imaging / Q000473:pathology; D011706:Pyloric Antrum / Q000000981:diagnostic imaging; D011859:Radiography; D012074:Remission Induction; D012189:Retrospective Studies; D013270:Stomach / Q000000981:diagnostic imaging; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D013276:Stomach Ulcer / Q000000981:diagnostic imaging / Q000473:pathology; D014839:Vomiting / Q000503:physiopathology
D000903:Antibiotics, Antineoplastic; D003287:Contrast Media