title: Primary gastric lymphoma: a clinicopathologic study.
abstract: OBJECTIVE
  This study aims to define the clinicopathologic criteria of primary gastric lymphoma in view of MALT concept and to present the outcome after different treatment modalities.
  
  
  METHODS
  Seventy-six cases of primary gastric lymphoma treated between January 1980 and December 2001 were reviewed. All tissue specimens (endoscopic or surgically resected) were re-examined. Tumors were staged according to Ann Arbor staging system and the Musshoff modification (IE in 30.3%, IIE in 39.4% and IIIE in 30.3%). Sixty patients underwent gastrectomy (partial or total) with postoperative chemotherapy for 32 patients. Sixteen patients were treated by chemotherapy only. The mean follow-up period was 15 years (range, 6 months to 21 years).
  
  
  RESULTS
  Primary gastric lymphoma represented 69.1% of cases of gastrointestinal lymphoma and 16.2% of all gastric malignancy. The mean age was 45 years and male to female ratio was 2.3:1. Epigastric pain was the commonest symptom (in 88.2%). Ulcer-like lesions were the commonest (65.8%) and the most commonly involved site was the lower third (48.7%). The resectability rate was 80%. The operative mortality rate was 2.7%. Another 2 cases died after partial gastrectomy and chemotherapy. Four cases in the chemotherapy group (25%) died. Tumor recurrence occurred in 4 cases (out of 32) after gastrectomy and chemotherapy (12.5%), 2 of them died and 2 were cured by chemotherapy. The mean overall survival was 18.49 years, survival was 20.28 years after gastrectomy, 15.48 years after gastrectomy with chemotherapy and 5.76 years after chemotherapy (p=0.0056).
  
  
  CONCLUSIONS
  Primary gastric lymphoma is not an uncommon tumor. Gastritis-like lesions are rare. If the tumor is resectable, gastrectomy will provide the most accurate means of diagnosis, staging and locoregional control of the disease.
authors.affiliation: Gastroenterology Surgery Center, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt. m_abu_zead@hotmail.com
authors.forename: Mostafa Abu
authors.initials: MA
authors.lastname: Zeid
authors.forename: Abdel Fatah
authors.initials: AF
authors.lastname: Elbedewy
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Awad
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005743:Gastrectomy / Q000401:mortality; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010146:Pain / Q000503:physiopathology; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents