title: Gastric involvement in patients with primary mediastinal large B-cell lymphoma.
abstract: Gastric involvement is unusual in primary mediastinal large B-cell lymphoma (PMLBCL), which has not yet been adequately studied. The aim of this retrospective study was to investigate the frequency of gastric involvement in 204 consecutive patients with PMLBCL that presented at 23 hospitals in Greece. Two out of 204 patients (1.0%) had gastric involvement at presentation. The first patient had symptomatic gastric disease manifested as upper gastrointestinal (GI) hemorrhage, which was the presenting symptom (first case reported in the literature). The second patient underwent positron emission tomography/computed tomography (PET/CT) at baseline staging which revealed abnormal gastric uptake. Histological examination revealed discordant lymphomatous involvement (MALT lymphoma, in a 33-year old female). The estimated frequency of gastric involvement by conventional staging was 1/204 (0.49%), but no cases were identified among asymptomatic patients. Among asymptomatic patients who underwent PET/CT at baseline staging, the PET/CT-based frequency of gastric involvement was 7.1%, but lymphomatous gastric involvement was discordant. Finally, the frequency of gastric involvement in primary progressive or relapsed disease was 2.2%. Our study shows that gastric involvement is uncommon but can be seen in different clinical settings at presentation or at progression/relapse of PMLBCL. PET/CT-based staging may provide more accurate information regarding the true incidence of sub-clinical gastric involvement in this entity, but histological confirmation is essential in order to confirm the diagnosis.
authors.affiliation: Second Department of Internal Medicine, Propaedeutic, Hematology Unit, Attikon General Hospital, University of Athens Medical School, Athens, Greece.
authors.forename: Sotirios G
authors.initials: SG
authors.lastname: Papageorgiou
authors.affiliation: Department of Haematology, Athens Medical Center, Psychiko Branch, Athens, Greece.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Sachanas
authors.affiliation: Department of Haematology, Athens Medical Center, Psychiko Branch, Athens, Greece.
authors.forename: Gerassimos A
authors.initials: GA
authors.lastname: Pangalis
authors.affiliation: Department of Haematology, Laikon General Hospital, University of Athens Medical School, Athens, Greece.
authors.forename: Olga
authors.initials: O
authors.lastname: Tsopra
authors.affiliation: Department of Pathology, Laikon General Hospital, University of Athens Medical School, Athens, Greece.
authors.forename: Georgia
authors.initials: G
authors.lastname: Levidou
authors.affiliation: Second Department of Pathology, Attikon General Hospital, University of Athens Medical School, Athens, Greece.
authors.forename: Periklis
authors.initials: P
authors.lastname: Foukas
authors.affiliation: Department of Nuclear Medicine and PET/CT, Evangelismos Hospital, Athens, Greece.
authors.forename: Phoivi
authors.initials: P
authors.lastname: Rondogianni
authors.affiliation: Department of CT, MRI and PET/CT, Athens Medical Center, Psychiko Branch, Athens, Greece.
authors.forename: Vasileios
authors.initials: V
authors.lastname: Sotiropoulos
authors.affiliation: Second Department of Internal Medicine, Propaedeutic, Hematology Unit, Attikon General Hospital, University of Athens Medical School, Athens, Greece.
authors.forename: Helen-Dikaia
authors.initials: HD
authors.lastname: Ioannidou
authors.affiliation: Department of Haematology, Laikon General Hospital, University of Athens Medical School, Athens, Greece.
authors.forename: Argyris
authors.initials: A
authors.lastname: Gassiamis
authors.affiliation: Department of Haematology, Laikon General Hospital, University of Athens Medical School, Athens, Greece.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Iliakis
authors.affiliation: Department of Pathology, Laikon General Hospital, University of Athens Medical School, Athens, Greece.
authors.forename: Penelope
authors.initials: P
authors.lastname: Korkolopoulou
authors.affiliation: Department of Haematology, Laikon General Hospital, University of Athens Medical School, Athens, Greece.
authors.forename: Maria K
authors.initials: MK
authors.lastname: Angelopoulou
authors.affiliation: Second Department of Internal Medicine, Propaedeutic, Hematology Unit, Attikon General Hospital, University of Athens Medical School, Athens, Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Pappa
authors.affiliation: Department of Haematology, Laikon General Hospital, University of Athens Medical School, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Konstantopoulos
authors.affiliation: Department of Haematology, Laikon General Hospital, University of Athens Medical School, Athens, Greece tvassilak@med.uoa.gr.
authors.forename: Theodoros P
authors.initials: TP
authors.lastname: Vassilakopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000150:complications* / Q000473:pathology / Q000628:therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000150:complications* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013272:Stomach Diseases / Q000209:etiology* / Q000473:pathology; D055815:Young Adult
keywords: Large B-cell lymphoma; hemorrhage; primary mediastinal; stomach