gastric lymphoma

Gastric Lymphoma: A Rare but Important Condition

Gastric lymphoma, also known as stomach lymphoma, is a rare type of cancer that affects the stomach. It accounts for approximately 5% of all stomach cancers and is the most common location for extranodal lymphomas, representing about 30-40% of these cases and 55-65% of lymphomas affecting the gastrointestinal tract [1][2][10][12].

Types of Gastric Lymphoma

Gastric lymphoma can be classified into several subtypes, including:

• Mucosa-associated lymphoid tissue (MALT) lymphoma: a slow-growing type of non-Hodgkin lymphoma that develops from B cells [8].
• Diffuse large B-cell lymphoma (DLBCL): an aggressive type of non-Hodgkin lymphoma that can spread quickly to other parts of the body.
• Gastric T-cell lymphoma: a rare and aggressive type of non-Hodgkin lymphoma that affects T cells.

Symptoms and Diagnosis

Gastric lymphoma can cause a range of symptoms, including:

• Gastrointestinal symptoms such as vomiting, abdominal pain, and weight loss
• Fatigue and weakness

Diagnosis is typically made through a combination of endoscopy, biopsy, and imaging tests [9][11].

Incidence and Prevalence

Gastric lymphoma is a relatively rare condition, accounting for less than 15% of gastric malignancies and about 2% of all lymphomas [1]. However, it is the most common source of lymphomas in the gastrointestinal tract.

Conclusion

In conclusion, gastric lymphoma is a rare but important condition that requires prompt attention. Early diagnosis and treatment can improve outcomes and reduce mortality rates. Further research is needed to better understand the causes, symptoms, and treatment options for this complex disease.

References:

[1] Primary gastric lymphoma is extranodal lymphoma that develops from lymphocytes in the stomach. It is different from secondary gastric lymphoma. [2] Universally, gastric lymphoma is the commonest gastrointestinal lymphoma except in a few countries where it is less common. [8] MALT lymphoma is a type of non-Hodgkin lymphoma that affects B cells and can be treated with antibiotics or chemotherapy. [9] Lymphoma of the stomach or gastric lymphoma accounts for 5% of all stomach cancers and causes gastrointestinal symptoms like vomiting and abdominal pain. [10] Gastric lymphoma accounts for approximately 5% of gastric neoplasms but is the most common location for extranodal lymphomas, representing about 30-40% of these cases and 55-65% of lymphomas affecting the gastrointestinal tract. [11] This entry looks at gastrointestinal lymphoma, better recognized as primary gastric lymphoma, or PGL, one of the subtypes of lymphoma. 'Lymphoma' is an umbrella term that loosely refers to several dozen independent categorical types and subtypes of cancers of the lymphatic system. [12] Gastric lymphoma accounts for approximately 5% of gastric neoplasms but is the most common location for extranodal lymphomas, representing about 30-40% of these cases and 55-65% of lymphomas affecting the gastrointestinal tract.

Common Signs and Symptoms of Gastric Lymphoma

Gastric lymphoma, a type of cancer that affects the stomach, can exhibit various signs and symptoms, which may be similar to those of other conditions. Here are some common symptoms associated with gastric lymphoma:

• Vague and nonspecific symptoms: Many people with gastric lymphoma may not experience any noticeable physical findings upon diagnosis, or their symptoms may be vague and non-specific.
• Epigastric pain: Pain in the upper abdomen, just below the breastbone, is a common complaint among patients with gastric lymphoma (6).
• Weight loss: Unintentional weight loss can occur due to a decrease in appetite or difficulty eating (12).
• Nausea and vomiting: Some people may experience nausea and vomiting, which can be caused by the tumor pressing on the stomach or intestines (5, 13).
• Abdominal pain: Pain in the abdomen, either sharp or dull, can occur due to the tumor's growth or the body's response to it (7, 8).
• Loss of appetite: A decrease in appetite can lead to weight loss and other symptoms (12).
• Bleeding: In some cases, gastric lymphoma can cause bleeding in the stomach or intestines, leading to bloody stools or black tarry stools (8).

Other Possible Symptoms

In addition to these common symptoms, some people with gastric lymphoma may experience:

• Fever: A persistent fever can be a sign of infection or inflammation related to the tumor.
• Night sweats: Night sweats can occur due to the body's response to the cancer.
• Fatigue: Feeling tired or weak can be a symptom of various conditions, including gastric lymphoma.

Important Note

It is essential to note that these symptoms can be similar to those experienced by people with other conditions. If you are experiencing any of these symptoms, it is crucial to consult a healthcare professional for proper diagnosis and treatment.

References:

• [6] The most common complaints of gastric lymphoma patients are epigastric pain, weight loss, nausea and vomiting.
• [12] Symptoms include epigastric pain, early satiety, fatigue and weight loss. Most people affected by primary gastric lymphoma are over 60 years old.
• [5] Lymphoma can sometimes start in the stomach if the body sends immune system cells to the stomach.
• [13] Lymphoma of the stomach or gastric lymphoma accounts for 5% of all stomach cancers. It causes gastrointestinal symptoms like vomiting and heart burn.
• [7] With more advanced disease, patients may present with nonspecific complaints including abdominal pain, nausea, vomiting, anorexia, weight loss, bleeding, fever, ...
• [8] Signs and Symptoms of Intestinal Lymphoma: Fever. Night sweats. Fatigue. Itchy skin. Painless swelling of lymph nodes in the belly, neck, armpits or groin. Pain in chest, abdomen or bones.
• [4] Primary gastric lymphoma (lymphoma that originates in the stomach itself) is an uncommon condition, ... Signs and symptoms. Symptoms include epigastric pain, early satiety, fatigue and weight loss. Most people affected by primary gastric lymphoma are over 60 years old.

Diagnostic Tests for Gastric Lymphoma

Gastric lymphoma, also known as stomach cancer, can be diagnosed using various tests and procedures. The following are some of the diagnostic tests used to diagnose gastric lymphoma:

• Upper Endoscopy: This is a test where a thin, flexible tube with a camera and light on the end (endoscope) is inserted through the mouth to visualize the inside of the stomach. Biopsy samples can be taken during this procedure to examine for cancer cells.
  • [5] Upper endoscopy is often done if the doctor thinks you might have stomach cancer.
• Blood Tests: Blood tests are used to check for abnormal levels of certain substances in the blood, such as lactate dehydrogenase (LDH), which can be elevated in people with lymphoma.
  • [13] Blood tests may be used to diagnose gastric lymphoma.
• Imaging Tests: Imaging tests such as CT scans and PET scans are used to visualize the inside of the body and check for any abnormalities, including cancer cells.
  • [3] The stomach is the most common site for lymphoma to start within the digestive system, and imaging tests may be used to diagnose gastrointestinal lymphoma.
• Biopsies: Biopsy samples can be taken from the stomach lining during an upper endoscopy or through a surgical procedure. These samples are then examined under a microscope to check for cancer cells.
  • [9] The diagnosis of gastrointestinal lymphoma can be made on endoscopic biopsies in the vast majority of cases.
• Endoscopic Ultrasound: This is a test where a thin, flexible tube with an ultrasound probe on the end (endoscope) is inserted through the mouth to visualize the inside of the stomach and surrounding tissues. Biopsy samples can be taken during this procedure to examine for cancer cells.
  • [15] Diagnostic assessments for gastric lymphomas include endoscopic biopsies, endoscopic ultrasounds, and other tests.

It's worth noting that a combination of these tests may be used to diagnose gastric lymphoma, and the specific tests used will depend on individual circumstances.

Treatment Options for Gastric Lymphoma

Gastric lymphoma, also known as stomach cancer, can be treated with various drug therapies. The choice of treatment depends on the type and stage of the disease.

• Antibiotic Therapy: For almost all cases of gastrointestinal MALT lymphoma, the first treatment used is antibiotics to eradicate H. pylori bacteria from the digestive system [10].
• Chemotherapy: Chemotherapy drugs such as Leukeran (chlorambucil) are occasionally an option if radiation treatments aren’t successful [2]. Combinations of chemo-immunotherapy drugs that might be used to treat MALT lymphoma include: rituximab plus bendamustine; rituximab plus chlorambucil [7].
• Immunotherapy: Immunotherapy and targeted therapy drugs are helpful for some lymphomas, such as mucosa-associated lymphoid tissue (MALT) lymphoma, which usually starts in the stomach [15].

Specific Chemotherapy Regimens

Some specific chemotherapy regimens used to treat gastric lymphoma include:

• CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), plus rituximab [8].
• Bendamustine plus rituximab [6].
• Chlorambucil plus rituximab [7].

Other Treatment Options

In addition to drug therapy, other treatment options for gastric lymphoma may include:

• Radiation therapy: Helps treat most cases of gastric lymphoma when antibiotic therapy doesn’t work [2].
• Surgery: May be used in some cases, especially if the cancer is localized and has not spread [13].

It's essential to note that the best treatment plan will depend on individual circumstances and should be discussed with a healthcare professional.

Differential Diagnoses for Gastric Lymphoma

Gastric lymphoma, a type of cancer that affects the stomach, can be challenging to diagnose due to its variable clinical presentation and wide differential diagnosis. Here are some possible conditions that may be considered in the differential diagnosis of gastric lymphoma:

• Acute Gastritis: Inflammation of the stomach lining, which can cause symptoms similar to those of gastric lymphoma.
• Atrophic Gastritis: A condition characterized by chronic inflammation and thinning of the stomach lining, which can increase the risk of developing gastric cancer or lymphoma.
• Bacterial Gastroenteritis: An infection caused by bacteria such as H. pylori, which can lead to symptoms like abdominal pain, diarrhea, and vomiting.
• Chronic Gastritis: Long-term inflammation of the stomach lining, which can cause symptoms similar to those of gastric lymphoma.
• Esophageal Cancer: A type of cancer that affects the esophagus, which can be considered in the differential diagnosis of gastric lymphoma due to overlapping symptoms.

Key Points

• Gastric lymphoma is a rare condition, accounting for approximately 5% of gastric neoplasms [10].
• The most common types of gastric lymphoma are mucosa-associated lymphoid tissue (MALT) lymphoma and diffuse large B-cell lymphoma (DLBCL) [10].
• A definitive diagnosis of gastric lymphoma cannot be made from gastroscopic brushings alone, and multiple biopsies may be required for accurate diagnosis [9].

References

[1] LM Juárez-Salcedo · 2018 · Cited by 151 [2] Jul 8, 2022 [3] by S Quan · 2016 [4] The definition of primary GI lymphoma has differed among authors, but typically refers to a lymphoma that predominantly involves any section of the GI tract from the oropharynx to the rectum [12]. [5] Gastric lymphoma accounts for approximately 5% of gastric neoplasms but is the most common location for extranodal lymphomas, representing about 30% to 40% of these cases and 55% to 65% of lymphomas affecting the gastrointestinal tract [10].