Endoscopic Semiotics of the Gastritis-Like Form of Primary Gastric Non-Hodgkin Lymphomas

AUTOIMMUNE THROMBOCYTOPENIA

VV Lozovaya1, OA Malikhova1,2, AO Tumanyan1

1 NN Blokhin National Medical Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

2 Russian Medical Academy of Postgraduate Education, 2/1 Barrikadnaya ul., Moscow, Russian Federation, 125993

For correspondence: Valeriya Vitalevna Lozovaya, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel.: +7(985)136-12-78; e-mail: lera.lozovaya@bk.ru

For citation: Lozovaya VV, Malikhova OA, Tumanyan AO. Endoscopic Semiotics of the Gastritis-Like Form of primary Gastric Non-Hodgkin Lymphomas. Clinical oncohematology. 2023;16(4):380–6. (In Russ).

DOI: 10.21320/2500-2139-2023-16-4-380-386

ABSTRACT

Aim. To characterize the main differentially significant endoscopic features specific to the gastritis-like form of primary gastric non-Hodgkin lymphomas (NHL).

Materials & Methods. This prospective study analyzes the results of complex endoscopic diagnosis in 43 patients with primary gastric NHL. They were examined and treated at the NN Blokhin National Medical Cancer Research Center from 2019 to 2023. The patients were 30–70 years of age, those over the age of 50 predominated and accounted for 79 % (n = 34). There were 33 women and 10 men. The control group included 45 patients with gastritis-like malignant gastric tumors: adenocarcinoma and signet-ring cell cancer.

Results. The morphological analysis yielded a diagnosis of MALT-lymphoma in 90.7 % (n = 39) and diffuse large B-cell lymphoma in 9.3 % (n = 4) of cases. Sensitivity, specificity, and accuracy of the clarification methods of complex endoscopic diagnosis were considerably higher compared to white-light mode examination. According to the results of complex endoscopic analysis, all patients were stratified into 4 groups with different types of H. pylori-induced atrophic gastritis (n = 10; 23.25 %), erosive gastritis (n = 10; 23.25 %), hyperplastic gastritis (n = 8; 18.6 %), and combined gastritis (n = 15; 34.9 %). The focus was laid on identifying the main differentially significant endoscopic features specific to the gastritis-like form of primary gastric NHL which distinguish it from the lesions in other malignant tumors.

Conclusion. The complex examination using 4 concrete clarification methods of endoscopic diagnosis is indispensable to properly interpret the detected changes and timely diagnose the gastritis-like form of primary gastric NHL. These include narrow-band imaging (NBI/BLI and LCI), close-focus and magnification examinations, combined narrow-band imaging and magnification examination, as well as endosonography.

Keywords: primary gastric non-Hodgkin lymphomas, MALT-lymphoma, gastritis-like form of primary gastric NHLs, endoscopic diagnosis.

Received: April 25, 2023

Accepted: September 5, 2023

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REFERENCES

  1. Ghimire P, Wu GY, Zhu L. Primary gastrointestinal lymphoma. World J Gastroenterol. 2011;17(6):697–707. doi: 10.3748/wjg.v17.i6.697.
  2. Shankland KR, Armitage JO, Hancock BW. Non-Hodgkin lymphoma. Lancet. 2012;380(9844):848–57. doi: 10.1016/S0140-6736(12)60605-9.
  3. Takigawa H, Masaki S, Naito T, et al. Helicobacter suis infection is associated with nodular gastritis‐like appearance of gastric mucosa‐associated lymphoid tissue lymphoma. Cancer Med. 2019;8(10):4370–9. doi: 10.1002/cam4.2314.
  4. Isomoto H, Matsushima K, Hayashi T, et al. Endocytoscopic findings of lymphomas of the stomach. BMC Gastroenterol. 2013;13:174. doi: 10.1186/1471-230X-13-174.
  5. Park BS, Lee SH. Endoscopic features aiding the diagnosis of gastric mucosa-associated lymphoid tissue lymphoma. J Yeungnam Med Sci. 2019;36(2):85–91. doi: 10.12701/yujm.2019.00136.
  6. Peng T, Deng L, Wang Y, et al. Establishing an endoscopic diagnostic process system (M-system) for gastric MALT lymphoma of superficial-spreading type. Jpn J Clin Oncol. 2021;51(4):560–8. doi: 10.1093/jjco/hyaa242.
  7. Janssen J. The impact of EUS in primary gastric lymphoma. Best Pract Res Clin Gastroenterol. 2009;23(5):671–8. doi: 10.1016/j.bpg.2009.05.008.
  8. Zullo A, Hassan C, Andriani A, et al. Primary low-grade and high-grade gastric MALT-lymphoma presentation. J Clin Gastroenterol. 2010;44(5):340–4. doi: 10.1097/MCG.0b013e3181b4b1ab.
  9. Малихова О.А. Современная стратегия комплексной эндоскопической диагностики и мониторинг неходжкинских лимфом желудка: Дис.… д-ра мед. наук. М., 2010. 291 с.
    [Malikhova OA. Sovremennaya strategiya kompleksnoi endoskopicheskoi diagnostiki i monitoring nekhodzhkinskikh limfom zheludka. (Modern strategy of complex endoscopic diagnosis and monitoring of gastric non-Hodgkin lymphomas.) [dissertation] Moscow; 2010. 291 p. (In Russ)]
  10. Suwa T, Uotani T, Inui W, et al. A case of signet ring cell carcinoma and mucosa-associated lymphoid tissue lymphoma of the stomach diagnosed simultaneously via magnifying endoscopy with narrow-band imaging. Clin J Gastroenterol. 2021;14(2):453–9. doi: 10.1007/s12328-020-01325-y.
  11. Iwamuro M, Tanaka T, Nishida K, et al. Two cases of gastric mucosa-associated lymphoid tissue (MALT) lymphoma masquerading as follicular gastritis. Ecancermedicalscience. 2019;13:933. doi: 10.3332/ecancer.2019.933.