Radiographic findings of primary B-cell lymphoma of the stomach: low-grade versus high-grade malignancy in relation to the mucosa-associated lymphoid tissue concept.
OBJECTIVE
We undertook this study to assess how well double-contrast radiography and CT allow radiologists to differentiate low-grade from high-grade mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach.


METHODS
We retrospectively reviewed the upper gastrointestinal radiographs and contrast-enhanced CT scans of 57 patients with pathologically proven primary gastric lymphoma (low-grade [n = 29] and high-grade [n = 28] MALT lymphoma).


RESULTS
On upper gastrointestinal radiography, ulceration (39%) was the most common finding in low-grade lymphoma, whereas polypoid appearance (38%) was the most common in high-grade lymphoma. In the 29 patients (33 lesions) with low-grade MALT lymphoma, upper gastrointestinal radiography revealed 13 ulcerative lesions (39%), 10 nodular lesions (30%), four infiltrative lesions (12%), two polypoid lesions (6%), and four combined lesions (12%). In the 28 patients (29 lesions) with high-grade lymphoma, upper gastrointestinal radiography revealed 11 polypoid lesions (38%), nine infiltrative lesions (31%), six ulcerative lesions (20%), one nodular lesion (3%), and two combined lesions (7%). On CT, thickening of the gastric wall in low-grade lymphoma (range, 0.3-2.5 cm; mean, 0.8 cm) was much less than that in high-grade lymphoma (range, 0.7-8.0 cm; mean, 2.5 cm). Abdominal lymphadenopathy was less frequent in low-grade lymphoma (14%) than in high-grade lymphoma (75%).


CONCLUSIONS
Most low-grade lymphomas show superficial spreading lesions, such as mucosal nodularity, shallow ulcer, and minimal fold thickening, on upper gastrointestinal radiography, whereas most high-grade lymphomas show mass-forming lesions or severe fold thickening.
Park
Mi-Suk
MS
Department of Diagnostic Radiology, Yonsei University College of Medicine, 134, Shinchon-dong, Seodaemun-Ku, Seoul 120-752, Korea.
Kim
Ki Whang
KW
Yu
Jeong-Sik
JS
Park
Chanil
C
Kim
Jai Keun
JK
Yoon
Sang-Wook
SW
Lee
Kwang-Hun
KH
Ryu
Young Hoon
YH
Kim
Haeryoung
H
Kim
Myeong-Jin
MJ
Lee
Jong Tae
JT
Yoo
Hyung Sik
HS
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003287:Contrast Media; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D018442:Lymphoma, B-Cell, Marginal Zone / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed
D003287:Contrast Media