ENDOSCOPIC FEATURES IN PATIENTS WITH MARGINAL ZONE LYMPHOMA OF MUCOSA ASSOCIATED LYMPHOID

TISSUE (MALT) IN A FOLLOW UP OF 10 YEARS

1N.V. Chrysanthos, 1S. Patsavela,1E. Anagnostopoulou,2A. Kolovou, 2K. Palla, 3A. Papanikolaou

1Gastrointestinal Department, 2Hematological Department″St George″ General Hospital Of Chania,

3Anatomopathological Department Evangelismos Hospital of Athens

• Gastrointestinal lymphoma is the most common type of extranodal lymphomas.

• Most commonly affects the stomach.

• The incidence of gastric MALT is increasing.

• Early diagnosis is still difficult, due to its non-specific symptoms and endoscopic findings.

• Gastric MALT is typically a low grade B-cell neoplasia, strongly associated with H.pylori infection.

• The diagnosis is made by endoscopic biopsy.

• Most commonly, its clinical presentation is characterised by non-specific gastrointestinal symptoms (vague dyspepsia, epigastric pain).

INTRODUCTION

• Early detection and accurate stage work up is essential for treatment.

• H.p eradication leads to complete regression in most of the cases.

• Unresponsive patients require other antineoplastic therapeutic approaches (radiotherapy, chemotherapy, or immunotherapy).

• Recurrence time varies and endoscopic surveillance is needed.

INTRODUCTION (cont.)

AIM Endoscopic features of patients with MALT at first diagnosis, recurrence

period, and follow up.

METHODSIt is a retrospective study which includes 18 patients with MALT in the last

decade.

Data were analyzed with SPSS 21.0.

RESULTS• Half of our patients had specific findings

[8/18 (44.4%), P: 0.69]• Most frequent endoscopic features of the

patients at initial diagnosis of ML were:

1. Erythematous gastritis (EG)2. Erosive gastritis 3. Gastric ulcers

0

5

10

15

20

25

30

35

40

ΕΡΥΘ ΓΑΣΤΡ ΔΙΑΒΡ ΕΛΚΗ

ΠΡΩΤΗ ΔΙΑΓΝΩΣΗ

• Recurrent disease presented significantly more frequent redness with whitish areas and edema [mucosal atrophy (AG)] [3/10 (30%), P: 0,02]

• Patients with minimal disease quite frequently exhibited EG and small nodular appearance of the mucosa [5/31 (16%) P:0.25 and 2/31 (6.4%) P:0.46].

• Patients with non-active disease frequently had EG [12/40 (30%), P: 0.78] and rarely AG [1/40 (2.5%), P: 0.19].

• MALT had a non-predictive biological attitude and could recur years after its first diagnosis.

• Upper endoscopy with multiple biopsies is the basic follow-up procedure.

RESULTS (cont.) CONCLUSIONS

Jeong Bae Park, Ja Seol Koo, ”Helicobacter pylori infection in gastric mucosa-associated lymphoid tissue lymphoma”, World J. Gastroenterology 2014 March 21; 20(11): 2751-2759.