Primary Low-grade and High-grade Gastric MALT-lymphoma Presentation: A Systematic Review.

Primary Low-grade and High-grade Gastric MALT-lymphoma Presentation: A Systematic Review.
J Clin Gastroenterol. 2009 Sep 9

Zullo A, Hassan C, Andriani A, Cristofari F, Cardinale V, Spinelli GP, Tomao S, Morini S.
*Gastroenterology and Digestive Endoscopy daggerHaematology, "Nuovo Regina Margherita" Hospital double daggerDepartment of Experimental Medicine, "La Sapienza" University, Rome, Italy.

GOALS: To assess the clinical and endoscopic presentation of primary gastric lymphoma.

BACKGROUND: Remission rate and long-term survival in patients with gastric lymphoma mainly depend on disease stage at diagnosis. Series reporting clinical and endoscopic presentation of gastric lymphoma are generally small and heterogeneous.

STUDY: Systematic review with pooled-data analysis assessing clinical and endoscopic presentation of primary gastric lymphoma.

RESULTS: Data regarding 2000 patients were collected. Overall, males were slightly more prevalent, alarm symptoms were absent in near half of the patients, lymphoma was diagnosed in a stage less then I in one-third of the patients, and Helicobacter pylori infection was present in 88.8% of considered patients. At endoscopy, the ulcerative type was the most frequent presentation, although low-grade lymphoma was diagnosed on normal/hyperemic gastric mucosa in 9% of cases. Patients with high-grade lymphoma presented alarm symptoms (anemia and/or melena and/or hemorrhage, persistent vomiting, weight loss), an exophytic or ulcerative lesion, a stage III-IV, and a H. pylori negative status more frequently than low-grade lymphoma cases.

CONCLUSIONS: Our pooled-data analysis showed that gastric lymphoma is still disappointingly diagnosed in an advanced stage in a large number of patients. This is probably due to presence of nonspecific symptoms at initial clinical presentation and/or a normal appearing mucosa at endoscopic observation in the early stages.

Lippincott, Williams & Wilkins