Primary low-grade and high-grade gastric MALT-lymphoma presentation

J Clin Gastroenterol. 2010 May-Jun;44(5):340-4. doi: 10.1097/MCG.0b013e3181b4b1ab.


Goal: 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 >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.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Female
  • Gastric Mucosa / pathology
  • Gastroscopy / methods*
  • Helicobacter Infections / complications
  • Helicobacter pylori / isolation & purification
  • Humans
  • Lymphoma, B-Cell, Marginal Zone / diagnosis
  • Lymphoma, B-Cell, Marginal Zone / microbiology
  • Lymphoma, B-Cell, Marginal Zone / pathology*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Remission Induction / methods
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / microbiology
  • Stomach Neoplasms / pathology*
  • Survival