Primary gastric lymphoma

ABSTRACT

To evaluate the clinico-pathological status of Primary Gastric Lymphoma [PGL] at presentation in King Fahad Hospital, Madina Munawra, Kingdom of Saudi Arabia [KSA]. A case series. Oncology Department of King Fahad Hospital, Madina Munawra, KSA, from 1990 to 1998. Case records of 22 patients with a histologically-confirmed diagnosis of PGL were analyzed. Tumors were staged according to the Ann Arbor Classification and divided according to the Rappaport working formulation. According to the treatment modality, different groups were established. Any other histopathological type was excluded from the study. Data were analyzed by frequency calculations. Survival was calculated from the date of surgery. All cases were Non-Hodgkin Lymphoma [NHL]. The peak age was in the sixth decades with a slight male preponderance. Most common presenting symptoms were epigastric or upper abdominal pain with or without mass. There were 10 [45%] patients with stage II, and 6 [27%] patients each with stage III and IV diseases. Diffuse large cell lymphoma was found in 12 [55%], poorly differentiated lymphoma in 3 [14%] and diffuse mixed in 7 [32%]. Helicobacter pylori infection was found in 2 [9%]. Sixteen [73%] patients underwent chemotherapy with some surgical resection, in 5 [23%] surgical procedure was palliative bypass and 11 [50%] had partial gastrectomy. Three [14%] had only chemotherapy after endoscopic biopsy. Two [9%] patients needed urgent surgical intervention. One [5%] patient had total gastrectomy followed by radiotherapy. Eleven [50%] had more than 3 years survival. PGL is usually of NHL type, presenting in the sixth decade, and can be successfully treated with both surgery and chemotherapy when patients presented at stage II. Chemotherapy after sub-total gastrectomy or biopsy was the best treatment option