Histological grading in gastric lymphoma: pretreatment criteria and clinical relevance

Gastroenterology. 1997 May;112(5):1466-74. doi: 10.1016/s0016-5085(97)70026-x.


Background & aims: Stomach-conserving therapy in primary gastric non-Hodgkin's lymphoma (mucosa-associated lymphoid tissue [MALT]-NHL) is increasingly gaining importance as an alternative to surgery. As a consequence, surgical pathologists have to define histological criteria in pretreatment endoscopic biopsy specimen samples not only to make the diagnosis but also to recognize minor tumor components that may infer a significantly adverse impact on prognosis. The aim of this study was to define histological criteria for clinically significant tumor progression in pretreatment endoscopic biopsy specimens.

Methods: In a consecutive series of 106 patients with gastric MALT-NHL, the prognostic impact of large cell components was assessed by semiquantitative analysis of clusters and diffusely intermingled malignant blasts.

Results: In low-grade MALT-NHL, a category with a diffuse large cell component of 1%-10% with or without nonconfluent clusters of blasts could be separated with a significantly worse prognosis (10-year disease-specific survival, 90% vs. 75%). No clinical parameters of known prognostic significance could account for this difference.

Conclusions: It is possible to define criteria in endoscopic biopsy specimens to recognize clinically relevant tumor progression. To serve as a guideline in the choice of treatment, these criteria should be validated prospectively in future clinical trials.

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Female
  • Gastric Mucosa / pathology
  • Humans
  • Lymphoid Tissue / pathology
  • Lymphoma, Non-Hodgkin / pathology*
  • Lymphoma, Non-Hodgkin / therapy
  • Male
  • Middle Aged
  • Prognosis
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / therapy
  • Survival Analysis
  • Treatment Outcome