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📘 Primary Gastric Lymphoma, Epidemiology, Clinical Diagnosis, and Treatment, Cancer Control. 2018
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Incidence
- The most common extranodal site for NHL is the stomach, making up 30-40% of extranodal lymphomas and 55-65% of gastrointestinal lymphomas.
- PGL is rare and representing 4-20% of NHL, more common in patients older than 50 years and is more prevalent in males.
- Histopathological subtype of PGL
- DLBCL: 59%.
- MALT lymphoma: 38%.
Clinical Presentation
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Primary gastric lymphoma (PGL) often presents with nonspecific symptoms similar to gastritis, peptic ulcer disease, pancreatic disorders, or functional stomach disorders.
| Common Symptoms |
Less Frequent Symptoms |
Uncommon Symptoms |
| Weight loss |
Weakness |
Gastric obstruction |
| Nausea |
Night sweats |
Perforation |
| Vomiting |
Jaundice |
Fever |
| Abdominal fullness |
Fever |
Hepatomegaly |
| Indigestion |
Dysphagia |
Splenomegaly |
|
|
Lymphadenopathy |
Diagnostic Studies
Standard Diagnostic Procedures
- EGD: Gold standard for biopsy and initial diagnosis.
- H. pylori Testing: IHC for tissue samples is necessary, with serology for active infection diagnosis.
Other Imaging Features
- CT Scan: Identifies systemic disease, lymph node extension, adjacent structure infiltration.
- MRI: Detects thickened mucosal folds, submucosal infiltration, constricting lesions, exophytic growth, mesenteric masses, and lymphadenopathy.
- EUS: Evaluates lesion extent, invasion, lymphomatous infiltration depth, perigastric lymph nodes.
- 18F-FDG-PET/CT: Used for primary gastric DLBCL due to variable FDG activity.
Pathogenesis