Clinical And Pathological Features Of Gastrointestinal Mucosa-associated Lymphoid Tissue Lymphoma

Purpose: We retrospectively examined 25 patients with primary gastrointestinal mucosa-associated lymphoid tissue (MALT) lymphoma to study the relationship among the clinicopathologic features > the histologic classification and the survival time.Cases and methods: By using HE staining and immunohistochemistry (ABC method), we diagnosed 25 cases of MALT lymphoma among 40 patients with primary gastrointestinal lymphoma who underwent excision. The clinical and pathological features N the histologic classification the presence of H.pylork therapy and prognosis were evaluated.Results: The median age of the patients was 45 years. The male-to-female ratio was 2.1:1. In 12 cases with gastric MALT lymphoma, 5 originated in the antrum^ 5 originated in the gastric corpus and 2 originated in the cardia. In 13 cases with intestinal lymphoma, 7originated in the region of the ileocecunu 3 in the jejunum and 3 in the ileum. Histologically, 17 patients had low grade lesions, 6 had combined low and high grade lesions (low>high), and 2 had high grade lesions. The morphology of the tumor cells was centrocyte-like cells for 15 casesN small lymphocyte-like cells for 8 cases ^ centroblaste-like cells for 2 cases. Reactive lymphoid follicles were detected in 9 cases of gastric MALT lymphoma (9/12). H.pylori was detected in 5 cases of gastric MALT lymphoma (5/12). Stage of disease was IE for 10 patients, IIEi for 11, IIE2 for 2, IVE for 2. The larger the tumor size, the higher the histological grade of tumor. Multivariated analysis revealed that histologic classification was significant factor in survival time.Conclusions: l.The prevalence of gastrointestinal MALT lymphoma in middle-age and old man is the highest. 2.Most gastrointestinal MALT lymphomas arise in the small intestine, closely followed by the stomach. In gastric MALT lymphoma, the antrum and the gastric corpus are the most common sites. In intestinal, the ileocecum is the most common site. 3. The symptoms of the gastrointestinal MALT lymphoma are non-specific. Constitutional B symptoms are exceedingly uncommon. The rate of misdiagnosis is high. Because the MALT lymphoma is often multifocal, the initial overall procedures comprising the endoscopy with multiple biopsies are essential to stage accurately. 4.HP infection might result in MALT lymphoma. Eradication of tLpylorishould be carried out before consideration of further therapeutic options. 5. The histologic classification is relative with the tumor size. The larger the tumor size, the higher the grade of tumor. 6. MALT lymphoma behaves as an indolent disease with a prolonged clinical course, but high grade might indicate poor prognosis.