|
1
|
Fischbach W, Neubauer A, Reinartz G. [Gastrointestinal mucosa-associated lymphoma]. INNERE MEDIZIN (HEIDELBERG, GERMANY) 2024; 65:690-700. [PMID: 38833003 DOI: 10.1007/s00108-024-01715-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 06/06/2024]
Abstract
Mucosa-associated lymphomas of the gastrointestinal tract are a heterogeneous group differing in pathogenesis, localization and therapeutic options. For all of them, differentiated treatment requires an exact determination of lymphoma stage. For gastric MALT lymphoma, the pathogenetic role of Helicobacter pylori infection has become evident in the last 30 years. These insights were consequently implemented into clinical practice. Nowadays, Helicobacter pylori eradication is the treatment of choice for gastric MALT lymphoma, leading to complete remission of the lymphoma in the majority of cases. In the absence of success, radiotherapy is available in localized stages I/II E with excellent results. Immuno-chemotherapy is the domain for advanced stages III/IV E, and surgery plays no role any more. The rare intestinal and colorectal MALT lymphomas require an individualized therapeutic approach.
Collapse
Affiliation(s)
- Wolfgang Fischbach
- Medizinische Klinik II und Klinik für Palliativmedizin, Klinikum Aschaffenburg-Alzenau, Akademisches Lehrkrankenhaus der Universität Würzburg, Aschaffenburg, Deutschland.
- Gastroenterologische Gemeinschaftspraxis Aschaffenburg, Elisenstraße 32, 63739, Aschaffenburg, Deutschland.
| | - Andreas Neubauer
- Klinik für Innere Medizin mit Schwerpunkt Hämatologie, Onkologie und Immunologie, Universitätsklinikum Gießen und Marburg, Standort Marburg, Carreras Leukämie Zentrum, Philipps-Universität Marburg, Baldingerstraße 1, 35043, Marburg, Deutschland
| | - Gabriele Reinartz
- Klinik für Strahlentherapie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| |
Collapse
|
|
2
|
Tingyu H, Jianqiang L, Zuguang X, Xiujiang Y, Ke C. Value of staging information provided by linear-array endoscopic ultrasound for therapeutic response and prognosis prediction in gastric lymphoma. Dig Endosc 2021; 33:929-938. [PMID: 33124105 DOI: 10.1111/den.13884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/22/2020] [Accepted: 10/27/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Currently, positron emission tomography/computed tomography (PET/CT)-based Ann Arbor and Lugano staging systems are widely applied for gastric lymphoma, which majorly focused on the extent of systemic invasion, but there is insufficient assessment in extent of gastric wall invasion. Thus, we aimed to assess the value of linear-array EUS in therapeutic response and prognosis prediction, and provide an endoscopic ultrasound (EUS)-based staging system for gastric lymphoma. METHODS Between January 2012 and October 2019, 191 patients with histologically confirmed gastric lymphoma were included. We analyzed patients' clinicopathologic data, white-light appearance, EUS staging, tumor extension, and therapeutic regime to identify the predictors for complete remission (CR) and progression-free survival (PFS). RESULTS With a median follow-up period of 547 days, 136 patients achieved CR. Multivariate regression analysis identified EUS T stage three CR predictors, including T stage (T2-T4 vs. T1, OR = 0.271, 95% confidence interval (CI) = 0.108-0.683, P = 0.0085) was the independent predictor. The Ki67 index, lesion surface, EUS stage, tumor extension, and regime predicted PFS, but tumor extension was the only independent predictor (local vs. system, OR = 6.005, 95%CI = 2.365-15.236, P < 0.001). The concordance index (C-index) was higher for CR rate in the EUS-based staging [0.673; 95% CI = 0.628-0.718] than Lugano staging [0.663; 95% CI 0.616-0.710], and for PFS in the EUS-based staging [0.694; 95% CI 0.586-0.802] than Lugano staging [0.684; 95% CI 0.564-0.804]. CONCLUSIONS An EUS-based staging system is suitable for CR and PFS prediction in gastric lymphoma, with highly informative assessment in extent of gastric wall invasion.
Collapse
Affiliation(s)
- Hu Tingyu
- Departments of, Endoscopy, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of, Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Liu Jianqiang
- Departments of, Endoscopy, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of, Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Xia Zuguang
- Department of, Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yang Xiujiang
- Departments of, Endoscopy, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of, Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Chen Ke
- Departments of, Endoscopy, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of, Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| |
Collapse
|
|
3
|
Matysiak-Budnik T, Jamet P, Ruskoné-Fourmestraux A, de Mascarel A, Velten M, Maynadié M, Woronoff AS, Trétarre B, Marrer E, Delafosse P, Ligier K, Lapôtre Ledoux B, Daubisse L, Bouzid L, Orazio S, Cowppli-Bony A, Monnereau A. Gastric MALT lymphoma in a population-based study in France: clinical features, treatments and survival. Aliment Pharmacol Ther 2019; 50:654-663. [PMID: 31347731 DOI: 10.1111/apt.15409] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 03/27/2019] [Accepted: 06/18/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a rare disease, and most available data on gastric MALT lymphoma (GML) come from clinical studies of selected patients treated in centres of excellence. AIMS To analyse the clinical features, management and survival of GML patients in a population-based study in France METHODS: All new cases of GML diagnosed between 2002 and 2010 in 11 French areas covered by cancer registries were included. Pathology reports were verified and, if necessary, reviewed by an expert pathologist. All clinical data were retrospectively collected from medical files and analysed using stata V. 14 software. RESULTS Four hundred and sixteen patients with confirmed GML (50% male, median age 67 years) were identified. Among them, 44 showed an early transformation into diffuse large B cell lymphoma and were considered to have had an initially missed high-grade lymphoma. At diagnosis, 76% of patients were at stage IE/II, and 24% at stage III/IV of the disease. Helicobacter pylori infection was found in 57% of the patients. Eradication treatment was administered to 76% of patients and complete remission (CR) was obtained in 39%. One hundred and ninety patients received at least one other treatment, including 10 already in CR after eradication. Altogether, CR was obtained in 70% of patients and the 5-year overall survival was 79% (95% CI [75-83]). CONCLUSIONS In comparison to clinical series, in the general population, GMLs are more frequently diagnosed at an advanced stage, their clinical management is heterogeneous, and there is a risk of misdiagnosis and overtreatment. These results highlight the necessity of following currently available guidelines in this field.
Collapse
|
|
4
|
Matysiak-Budnik T, Fabiani B, Hennequin C, Thieblemont C, Malamut G, Cadiot G, Bouché O, Ruskoné-Fourmestraux A. Gastrointestinal lymphomas: French Intergroup clinical practice recommendations for diagnosis, treatment and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, SFH). Dig Liver Dis 2018; 50:124-131. [PMID: 29301732 DOI: 10.1016/j.dld.2017.12.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 11/26/2017] [Accepted: 12/04/2017] [Indexed: 12/11/2022]
Abstract
INTRODUCTION This document is a summary of the French Intergroup guidelines on the management of gastro-intestinal lymphomas, available on the web-site of the French Society of Gastroenterology, SNFGE (www.tncd.org), updated in September 2017. METHODS This collaborative work was realised under the auspices of several French medical societies and involved clinicians with specific expertise in the field of gastrointestinal lymphomas, including gastroenterologists, haematologists, pathologists, and radiation oncologist, representing the major French or European clinical trial groups. It summarises their consensus on the management of gastrointestinal lymphomas, based on the recent literature data, previous published guidelines and the expert opinions. RESULTS The clinical management, and especially the therapeutic strategies of the gastro-intestinal lymphomas are specific to their histological subtypes and to their locations in the digestive tract, with the particularity of gastric MALT lymphomas which are the most frequent and usually related to gastritis induced by Helicobacter pylori. CONCLUSION Lymphomas are much less common than epithelial tumours of gastro-intestinal digestive tract. Their different histological subtypes determine their management and prognosis. Each individual case should be discussed within the expert multidisciplinary team.
Collapse
Affiliation(s)
- Tamara Matysiak-Budnik
- Institut des Maladies de l'Appareil Digestif, CHU, Hôtel Dieu, GELD (Groupe d'Etude des Lymphomes Digestifs), Nantes, France, France.
| | - Bettina Fabiani
- GHU Est Parisien-Hôpital St. Antoine, APHP, GELD, Paris, France
| | - Christophe Hennequin
- GHU Paris Nord-Hôpital St. Louis, APHP, LYSA (Lymphoma Study Association), Paris, France
| | - Catherine Thieblemont
- GHU Paris Nord-Hôpital St. Louis, APHP, LYSA (Lymphoma Study Association), Paris, France
| | - Georgia Malamut
- GHU Ouest- Hôpital Européen Georges Pompidou, APHP, CELAC (Centre d'Expert national des Lymphomes Associés à la maladie Coeliaque), Paris, France
| | | | | | | |
Collapse
|
|
5
|
Reinartz G, Weiglein T, Dreyling M, Oertel M. Radiation Therapy in Marginal Zone B-Cell Lymphomas. Radiat Oncol 2017. [DOI: 10.1007/978-3-319-52619-5_24-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
|
6
|
Wotherspoon AC, Du MQ, Spencer J. Gastrointestinal Lymphoma. Mucosal Immunol 2015. [DOI: 10.1016/b978-0-12-415847-4.00089-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
|
7
|
Park JB, Koo JS. Helicobacter pylori infection in gastric mucosa-associated lymphoid tissue lymphoma. World J Gastroenterol 2014; 20:2751-2759. [PMID: 24659867 PMCID: PMC3961970 DOI: 10.3748/wjg.v20.i11.2751] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 10/15/2013] [Accepted: 11/03/2013] [Indexed: 02/06/2023] Open
Abstract
Gastrointestinal lymphoma is the most common type of extranodal lymphoma, and most commonly affects the stomach. Marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) and diffuse large B-cell lymphoma are the most common histologic types of gastric lymphoma. Despite its increasing incidence, diagnosis of gastric lymphoma is difficult at an earlier stage due to its nonspecific symptoms and endoscopic findings, and, thus, a high index of suspicion, and multiple, deep, repeated biopsies at abnormally and normally appearing sites in the stomach are needed. In addition, testing for Helicobacter pylori (H. pylori) infection and endoscopic ultrasonography to determine the depth of tumor invasion and involvement of regional lymph nodes is essential for predicting response to H. pylori eradication and for assessment of disease progression. In addition, H. pylori infection and MALT lymphoma development are associated, and complete regression of low-grade MALT lymphomas after H. pylori eradication has been demonstrated. Radiotherapy and/or chemotherapy can be used in cases that show poor response to H. pylori eradication, negativity for H. pylori infection, or high-grade lymphoma.
Collapse
|
|
8
|
Vetro C, Chiarenza A, Romano A, Amico I, Calafiore V, Di Raimondo C, Coppolino F, Di Raimondo F. Prognostic assessment and treatment of primary gastric lymphomas: how endoscopic ultrasonography can help in tailoring patient management. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2013; 14:179-85. [PMID: 24369919 DOI: 10.1016/j.clml.2013.10.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 10/03/2013] [Accepted: 10/21/2013] [Indexed: 12/18/2022]
Abstract
Endoscopic ultrasonography (EUS) has recently gained a pivotal role in the management of gastric lymphomas, especially in the diagnostic workup. Its accuracy and reliability have overcome those of other imaging techniques, such that it represents an invaluable tool for the management of gastric lymphomas. Although this technique is operator dependent, its application in large series has proved its reliability. Thus, it has generally been considered a useful tool for providing information crucial in deciding the treatment program, especially for mucosa-associated lymphoid tissue (MALT) lymphomas, for which EUS can provide an accurate evaluation of disease extension and treatment response probability. Limited-stage disease, confined to the submucosa, has a greater probability to respond to sole Helicobacter pylori eradication. In contrast, the value of EUS in response assessment and follow-up monitoring is still debated, with discordant opinions about its reliability and clinical advantages, because normalization of the EUS findings occurs with a considerable delay compared to the histologic evaluation. In the follow-up setting, preliminary data have indicated that persistently positive EUS findings in low-grade gastric lymphoma could represent a warning for a possible relapse. However, in high-grade gastric lymphoma, such findings do not have any clinical implications.
Collapse
Affiliation(s)
- Calogero Vetro
- Division of Hematology, AOU Policlinico-OVE, University of Catania, Catania, Italy
| | - Annalisa Chiarenza
- Division of Hematology, AOU Policlinico-OVE, University of Catania, Catania, Italy
| | - Alessandra Romano
- Division of Hematology, AOU Policlinico-OVE, University of Catania, Catania, Italy
| | - Irene Amico
- Division of Hematology, AOU Policlinico-OVE, University of Catania, Catania, Italy
| | - Valeria Calafiore
- Division of Hematology, AOU Policlinico-OVE, University of Catania, Catania, Italy
| | | | | | | |
Collapse
|
|
9
|
Boot H. Diagnosis and staging in gastrointestinal lymphoma. Best Pract Res Clin Gastroenterol 2010; 24:3-12. [PMID: 20206103 DOI: 10.1016/j.bpg.2009.12.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Revised: 12/07/2009] [Accepted: 12/21/2009] [Indexed: 02/06/2023]
Abstract
The diagnosis gastrointestinal lymphoma can be made on endoscopic biopsies in the vast majority of cases. Definitive subtyping of the lymphoma according to the WHO classification with the use of additional immunological and molecular markers is the cornerstone for further decision making. Several lymphomas may occur multifocally or show both small cell and large cell components. Therefore, a second endoscopy with an extensive biopsy protocol (mapping) may be mandatory. Staging procedures are required for therapeutic decision making and should include CT-scan, laboratory studies and bone marrow examination as required in other lymphomas. Additional studies must be performed depending subtype and localisation of the lymphoma. In gastric lymphoma endosonography reveals prognostic information. In marginal zone lymphoma of MALT-type attention to other MALT-sites and autoimmune diseases is necessary. In enteropathy-associated T-cell lymphoma screening for coeliac disease and enteroscopy are required. In several lymphomas (diffuse large B-cell lymphoma and mantle cell lymphoma) a PET-scan is considered as standard of care. The value of staging procedures after treatment is less well defined. At least in gastric lymphomas, histology is the gold standard after treatment and during follow-up.
Collapse
Affiliation(s)
- Henk Boot
- Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Medical Oncology and Gastroenterology, Amsterdam, The Netherlands.
| |
Collapse
|
|
10
|
Fischbach W, Al-Taie O. Staging role of EUS. Best Pract Res Clin Gastroenterol 2010; 24:13-7. [PMID: 20206104 DOI: 10.1016/j.bpg.2009.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Revised: 11/24/2009] [Accepted: 11/25/2009] [Indexed: 01/31/2023]
Abstract
Type of lymphoma and stage of disease are the two decisive prognostic factors and therapeutic determinants. For the locoregional staging, i.e. assessment of the gastric wall infiltration and perigastric lymphonodular involvement, endoscopic ultrasound (EUS) is highly useful. EUS has, therefore, to be integrated into the standard staging procedure of gastric lymphoma, although its impact on initial treatment decisions might be limited in the individual case. A benefit from the use of miniechoendoscopes, EUS elastography and EUS-guided biopsies has not yet been proven in gastric lymphoma. EUS also confers an important prognostic value regarding treatment responses to Helicobacter pylori eradication. On the contrary, EUS cannot be recommended as a regular part of follow-up investigations considering its limited value in predicting the response of the lymphoma to radiation or chemotherapy.
Collapse
Affiliation(s)
- W Fischbach
- Medizinische Klinik II und Klinik für Palliativmedizin, Klinikum Aschaffenburg, Akademisches Lehrkrankenhaus der Universität Würzburg, Germany.
| | | |
Collapse
|
|
11
|
The impact of EUS in primary gastric lymphoma. Best Pract Res Clin Gastroenterol 2009; 23:671-8. [PMID: 19744632 DOI: 10.1016/j.bpg.2009.05.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2009] [Accepted: 05/26/2009] [Indexed: 01/31/2023]
Abstract
Gastric lymphoma is the most frequent site of gastrointestinal lymphoma and is accessible for endosonographic evaluation. Most primary gastric lymphomas are classified as mucosa-associated lymphoid tissue (MALT)-type lymphomas that develop in the course of chronic Helicobacter pylori infection. Endoscopic ultrasonography (EUS) is regarded to be the most accurate method for the local staging of gastric lymphoma, although scientific evidence is limited. In stage uEI1 low-grade lymphoma, EUS is able to predict a high chance for cure by H. pylori eradication. The significance of EUS elastography or EUS-guided fine-needle aspiration biopsy to diagnose nodal involvement has not been investigated in prospective series yet. Since high-grade lymphoma is always treated as a systemic disease, the impact of endosonographic staging is lower than in low-grade lymphoma. After treatment of primary gastric lymphoma, EUS produces conflicting results that are not as accurate as endoscopy with biopsy. Therefore, EUS is not mandatory during follow-up.
Collapse
|
|
12
|
Wang N, Fu Q, Wang YJ. Advances on the treatment of gastric mucosa-associated lymphoid tissue lymphoma. Shijie Huaren Xiaohua Zazhi 2007; 15:860-868. [DOI: 10.11569/wcjd.v15.i8.860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Gastric mucosa-associated lymphoid tissue (MALT) lymphomas are rare in the gut, and its occurrence rate was 1% to 5% of the malignant tumors. In histological type, most of them are non-Hodgin's lymphomas, while Hodgin's lymphomas are seldom seen. There have been a lot of controversies on the optimal treatments of gastric MALT lymphomas for a long time. Surgery was traditionally considered as the most important approach to cure the disease. However, anti-H. pylori therapy has been regarded as an alternative method since H. pylori infection was found to be relevant with the pathogenesis of gastric MALT lymphomas. In this article, we reviewed the current status and recent advances on the treatment of this disease.
Collapse
|
|
13
|
Dickson BC, Serra S, Chetty R. Primary gastrointestinal tract lymphoma: diagnosis and management of common neoplasms. Expert Rev Anticancer Ther 2007; 6:1609-28. [PMID: 17134365 DOI: 10.1586/14737140.6.11.1609] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Primary gastrointestinal lymphoma represents the most common location of extranodal lymphoma. With the bulk of disease manifesting within the gastrointestinal tract and contiguous lymph nodes, many of the lymphomas occurring in the peripheral lymph nodes can also present with primary gastrointestinal tract involvement. Molecular biology has recently enabled significant progress in the diagnosis and management of primary gastrointestinal lymphoma. Herein, we will discuss the major lymphomas affecting the bowel and highlight their key morphological, immunophenotypical and molecular diagnostic attributes. Similarly, in keeping with recent therapeutic advances, we will briefly discuss some important treatment considerations. Thus, this review is intended to offer clinicians and pathologists an overview of primary gastrointestinal lymphomas.
Collapse
Affiliation(s)
- Brendan C Dickson
- University of Toronto, Department of Laboratory Medicine and Pathobiology, Toronto General Hospital, Department of Pathology, 200 Elizabeth Street, 11th Floor, Residents and Fellows Room, Toronto, Ontario, Canada.
| | | | | |
Collapse
|
|
14
|
Ferrucci PF, Zucca E. Primary gastric lymphoma pathogenesis and treatment: what has changed over the past 10 years? Br J Haematol 2006; 136:521-38. [PMID: 17156403 DOI: 10.1111/j.1365-2141.2006.06444.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Primary gastric (PG) lymphomas are generally non-Hodgkin lymphomas (NHL). They represent 5% of gastric malignancies and show an apparently increasing incidence worldwide. The most common histological subtypes are diffuse large B-cell and marginal zone B-cell NHL of the mucosa-associated lymphoid tissue (MALT)-type. Pathogenesis is often related to Helicobacter pylori infection (HPI). There is still no consensus on the optimal treatment for PG lymphoma. Nowadays surgery is limited to rare cases and radiotherapy--combined or not with chemotherapy--represents an effective therapeutic option ensuring long-term, organ-salvage benefits mainly in aggressive histological subtypes. Additionally, the description of MALT lymphomas has made the situation even more complex, because antibiotics alone can induce lasting remissions in those cases associated with HPI. Consequently, a global therapeutic approach to the cure of PG-NHL has completely changed over the last 10 years: innovative, conservative options to reduce treatment toxicity, thus preventing systemic relapses, have made their appearance and are on the rise.
Collapse
MESH Headings
- Helicobacter Infections/complications
- Helicobacter pylori
- Humans
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/etiology
- Lymphoma, B-Cell/therapy
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/etiology
- Lymphoma, B-Cell, Marginal Zone/therapy
- Lymphoma, Non-Hodgkin/diagnosis
- Lymphoma, Non-Hodgkin/etiology
- Lymphoma, Non-Hodgkin/therapy
- Stomach Neoplasms/diagnosis
- Stomach Neoplasms/etiology
- Stomach Neoplasms/therapy
Collapse
|
|
15
|
Fischbach W. [Gastric lyphoma - still a result of surgery?]. Chirurg 2006; 77:512, 514-7. [PMID: 16773350 DOI: 10.1007/s00104-006-1187-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In extranodal non-Hodgkin's lymphoma (NHL), the gastrointestinal tract is by far the most frequent localization. One must differentiate between primary lymphoma, e.g. those arising in the gastrointestinal tract, and secondary lymphoma, which can affect the digestive tract as a disseminations of nodal lymphoma. Analysis of histomorphologic and immunhistochemical characteristics and the concept of mucosa-associated lymphoid tissue (MALT) have led to primary gastrointestinal lymphoma now being viewed as an independent entity. The great majority of gastric lymphoma (>90%) are marginal zone B-cell lymphoma of the MALT type, previously called low grade MALT lymphoma, and diffuse large B-cell lymphoma, previously called high grade gastric lymphoma. This review examines current views on pathogenesis, diagnosis, and therapy of this disorder.
Collapse
MESH Headings
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Agents/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols
- Biopsy
- Combined Modality Therapy
- Cyclophosphamide
- Diagnosis, Differential
- Doxorubicin
- Helicobacter Infections/complications
- Helicobacter pylori
- Humans
- Lymphoma/diagnosis
- Lymphoma/drug therapy
- Lymphoma/etiology
- Lymphoma/mortality
- Lymphoma/pathology
- Lymphoma/radiotherapy
- Lymphoma/surgery
- Lymphoma, B-Cell/classification
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/therapy
- Lymphoma, T-Cell/classification
- Lymphoma, T-Cell/diagnosis
- Lymphoma, T-Cell/pathology
- Neoplasm Staging
- Prednisone
- Prognosis
- Prospective Studies
- Radiotherapy Dosage
- Randomized Controlled Trials as Topic
- Retrospective Studies
- Rituximab
- Stomach/pathology
- Stomach Neoplasms/diagnosis
- Stomach Neoplasms/drug therapy
- Stomach Neoplasms/etiology
- Stomach Neoplasms/mortality
- Stomach Neoplasms/pathology
- Stomach Neoplasms/radiotherapy
- Stomach Neoplasms/surgery
- Time Factors
- Vincristine
- World Health Organization
Collapse
Affiliation(s)
- W Fischbach
- Medizinische Klinik II, Klinikum Aschaffenburg, Lehrkrankenhaus der Universität Würzburg, Am Hasenkopf, 63739 Aschaffenburg.
| |
Collapse
|
|
16
|
N/A, 巴 明, 卿 三, 李 国, 闻 英. N/A. Shijie Huaren Xiaohua Zazhi 2005; 13:582-583. [DOI: 10.11569/wcjd.v13.i4.582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
|
|
17
|
Barakat J, Kaufman J, Monnin K, Qaseem T. Epstein-Barr virus-negative gastric large B-cell lymphoma after kidney transplantation. Gastrointest Endosc 2003; 57:951-5. [PMID: 12776054 DOI: 10.1016/s0016-5107(03)70052-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Jehad Barakat
- Department of Internal Medicine and Pathology, Division of Gastroenterology/Hepatology, University of New Mexico Health Science Center, Albuquerque 87131-5271, USA
| | | | | | | |
Collapse
|