Yeungnam Univ J Med.  2019 May;36(2):85-91. 10.12701/yujm.2019.00136.

Endoscopic features aiding the diagnosis of gastric mucosa-associated lymphoid tissue lymphoma

• Park BS
• Lee SH

• KMID: 2449319
• DOI: http://doi.org/10.12701/yujm.2019.00136

Abstract

The incidence of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is increasing worldwide, but the diagnosis is difficult. Most patients are asymptomatic or complain of nonspecific gastrointestinal symptoms. As the endoscopic features of gastric MALT lymphoma are variable and nonspecific, the possibility of this condition may be overlooked during esophagogastroduodenoscopy, and it remain undiagnosed. Therefore, this condition needs to be considered when an abnormal mucosa is observed during this procedure. Biopsy performed during endoscopy is the primary diagnostic test, but false negative results are possible; large numbers of samples should be collected from both normal and abnormal mucosae. Endoscopic ultrasonography is useful to assess the depth of invasion and to predict the treatment response. After treatment, follow-up tests are required every 3 months until complete remission is achieved, and annually thereafter. Early diagnosis of gastric MALT lymphoma is difficult, and its diagnosis and follow-up require wide experience and competent endoscopic technique.

Keyword

Diagnosis; Follow-up studies; Gastrointestinal endoscopy; Marginal zone B-cell lymphoma; Stomach neoplasms

MeSH Terms

Biopsy
Diagnosis*
Diagnostic Tests, Routine
Early Diagnosis
Endoscopy
Endoscopy, Digestive System
Endoscopy, Gastrointestinal
Endosonography
Follow-Up Studies
Humans
Incidence
Lymphoid Tissue
Lymphoma
Lymphoma, B-Cell, Marginal Zone*
Mucous Membrane
Stomach Neoplasms

Figure

• 

  Fig. 1. Endoscopic findings of gastric mucosa-associated lymphoid tissue lymphoma. (A) Exophytic type. (B) Ulceroinfiltrative type. (C) IIc-like type. (D) Submucosal tumor type. (E) Multiple erosion type. (F) Cobblestone mucosa type. (G) Partial fold swelling type. (H) Discoloration type.

• 

  Fig. 2. Endoscopic ultrasonography findings of gastric mucosa-associated lymphoid tissue lymphoma. (A) Tumor limited to the mucosa. (B) Tumor invading the submucosa.

• 

  Fig. 3. Endoscopic findings of gastric MALT lymphoma after treatment. Mucosa, which was diagnosed as MALT lymphoma, had changed to atrophic and whitish discolored mucosa after Helicobacter pylori eradication. MALT, mucosa-associated lymphoid tissue.

Reference

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