Incidence of gastric involvement in patients with nongastrointestinal extranodal marginal zone lymphoma.
BACKGROUND
The current study was conducted to determine the incidence of gastric involvement in patients presenting with extranodal marginal zone lymphoma (MZL) outside the gastrointestinal (GI) tract and to identify clinical or laboratory parameters that predict gastric involvement in such cases.


METHODS
The records of 121 consecutive patients who presented with non-GI extranodal MZL and had undergone esophagogastroduodenoscopy (EGD) as part of their initial workup were retrospectively reviewed. The authors assessed the presence of occult gastric MZL in these patients and possible associations with demographic characteristics; anatomic site of initial presentation; Helicobacter pylori (H. pylori) infection; Zubrod score; International Prognostic Index (IPI); B symptoms; and serum lactate dehydrogenase, hemoglobin, albumin, and β2-microglobulin levels.


RESULTS
The median age at diagnosis of non-GI MZL was 59 years. The most common primary tumor sites were the salivary/parotid gland (32 patients), ocular adnexa (26 patients), skin (19 patients), and lung (17 patients). Twenty-two patients (18%) were found to have gastric involvement on EGD. Using logistic regression analysis, factors found to be associated with gastric involvement included: high IPI score (odds ratio [OR], 3.70; P = .03), female sex (OR, 6.50; P = .02), serum β2-microglobulin level of ≥ 2.5 mg/L (OR, 3.69; P = .02), and involvement of the aerodigestive mucosal/glandular tissue (OR, 4.50; P = .004). On multivariate logistic analysis, aerodigestive mucosal/glandular sites, H. pylori infection, and an elevated β2-microglobulin level were found to be associated with gastric involvement.


CONCLUSIONS
Routine EGD is recommended for patients with non-GI MZL, particularly those with primary aerodigestive mucosal/glandular tissue involvement or those with a high IPI, female sex, elevated serum β2-microglobulin level, or H. pylori infection regardless of the primary tumor site.
Public Health Department, University of Texas Health Science Center, Houston, Texas.
Ali
A
Mazloom
Alma
A
Rodriguez
Chul S
CS
Ha
L Jeffery
LJ
Medeiros
Christine
C
Wogan
Ferial
F
Shihadeh
Pamela
P
Allen
Nathan
N
Fowler
Bouthaina
B
Dabaja
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D018442:Lymphoma, B-Cell, Marginal Zone / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology; D055815:Young Adult
aerodigestive; extranodal; gastric; marginal zone lymphoma; β2-microglobulin