The Role of Endoscopic Ultrasonography in Primary Gastric Lymphoma of MALT

Lee, Chung Ryul; Cho, Young Suk; Cheong, Jae Youn; Lee, Yong Chan; Chung, Jae Bock; Chon, Jae Yoon; Moon, Young Myung; Kang, Jin Kyung; Park, In Suh

Abstract

BACKGROUND AND AIMS
Endoscopic ultrasonography (EUS) is a useful diagnostic method for diagnosing local invasion and lymph node metastasis of primary gastric lymphoma including mucosa-associated lymphoid tissue (MALT) lymphoma, but the role of follow-up EUS after histologic regression of MALT lymphoma has not been well established until now. Therefore the usefulness of EUS in initial and follow up studies after Helicobacter pylori eradication therapy was investigated.
METHODS
From January 1995 to October 1998, nineteen MALT lymphoma patients were investigated. All but four patients underwent EUS exam at diagnosis and 3~23 months thereafter. 17 patients recieved H. pylori eradication therapy and 2 patients recieved operations without medical treatment.
RESULTS
16 of the 17 patients (94%) were cured of H. pylori infection after antimicrobial therapy. but on the histologic criteria, 13 of the 16 cases (81%) who were cured of H. pylori infection showed complete regression of MALT lymphoma. Histologic regression of MALT lymphoma was observed 6 weeks to 23 months after H. pylori eradication. In follow up EUS exam, gastric wall abnormalities returned to normal in 9 cases (69%) and remained abnormal in 4 cases (31%) among the completely regressed 13 cases.
CONCLUSIONS
Considerable portion (31%) of follow up EUS exam showed persistent abnormalities of gastric wall such as thickening of mucosa and/or submucosa after histologic regression of MALT lymphoma. To evaluate the usefulness of EUS, follow up EUS exam with regular interval for longer periods after histologic regression is needed.