ABSTRACT
Background: The traditional methods to distinguish Chronic Follicular Gastritis and Primary Gastric Lymphoma do not allow an adequate definitive diagnosis in a significant number of cases. The Molecular Biology diagnostic methods are based on the rearrangement of immunoglobulin genes. The polymerase chain reaction (PCR) specifically amplifies this rearrangement and allows molecular analysis of minimal tissue samples obtained with endoscopical biopsies. Aim: To test the usefulness of this PCR method in the differential diagnosis between Chronic Follicular Gastritis and Primary Gastric Lymphoma. Material and methods: We analyzed the endoscopical biopsies of six Chronic Follicular Gastritis cases and eight surgically treated Primary Gastric Lymphoma cases, six with the correct diagnosis in the endoscopical biopsies and two with a diagnosis of Chronic Follicular Gastritis. Results: A policlonal immunoglobulin rearrangement was found in the six cases with Chronic Follicular Gastritis. A monoclonal arrangement was found in 5 of 6 biopsies with the diagnosis of Primary Gastric Lymphoma. The same monoclonal rearrangement was observed in the two biopsies incorrectly diagnosed as Chronic Follicular Gastritis. Conclusions: PCR analysis of immunoglobulin rearrangement is a useful method in the differential diagnosis between Chronic Follicular Gastritis and Primary Gastric Lymphoma
Subject(s)
Humans , Stomach Neoplasms/diagnosis , Immunoglobulins , Lymphoma/diagnosis , Gastritis, Hypertrophic/diagnosis , Stomach Neoplasms/etiology , Stomach Neoplasms/pathology , Biopsy , Polymerase Chain Reaction , Lymphoma/etiology , Lymphoma/pathology , Diagnosis, Differential , Gastritis, Hypertrophic/complications , Gastritis, Hypertrophic/pathologyABSTRACT
To analyze the clinical presentation, pathological aspect and trealment of gastric adenomas, a retrospective analysis of 75 patients aged 26 to 88 years in whom a gastric adenoma was diagnosed. Seventy one patients had elevated endoscopical lesions and two had depressed or flat lesions. Ninety percent of lesions were located in the gastric antrum. Pathological study detected 6 focal carcinomas within the adenomas and 5 concomitant carcinomas located elsewhere in the stomach. Fifty four patients were subjected to endoscopical resection. Among patients with focal carcinomas, a gastrectomy was performed in four and endoscopical resection in two. Gastric adenomas must be considered in the differential diagnosis of gastric elevated lesions and may be confused in early gastric cancer. There is a histological resemblance between adenomas and gastric dysplasia descibed by several authors though only in our cases and in the Japanese literature the adenoma is referred to as mostly a polypoid sessile lesion