Clinical Gastroenterology Vol.13 No.3(3)

Theme Malignant Lymphoma of the GI Tract
Title Endoscopic Findings and Features of Primary Gastric Lymphoma
Publish Date 1998/03
Author Taiji Akamatsu Department of Endoscopy, Shinshu University Hospital
[ Summary ] Endoscopic findings and features of primary gastric lymphoma (PGL) were categorized according to Fujino's macroscopic classification of PGL, namely l) superficial type, 2) protruding type, 3) ulcerative type, and 4) diffuse infiltrating type. It is necessary to distinguish the superficial type of PGL from gastritis and early gastric cancer, we should especially take care not to overlook this type which is similar to gastritis. On the other hand, it is necessary to differentiate protruding type, ulcerative type, and diffuse infiltrating type of PGL from submucosal tumor and advanced gastric cancer. However, it is usually easy to diagnose these types of PGL as malignant tumors. When we suspect PGL from endoscopic findings, we should take a biopsy from an appropriate point and report these observations clearly to a pathologist. In the case of difficulty distinguishing between malignant lymphoma and reactive lymphoid hyperplasia by conventional biopsy, jumbo biopsy using endoscopic mucosal resection and molecular biological techniques with polymerase chain reaction would be useful procedures for making the differential diagnosis.
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