[Clinical and morphological aspects of MALT-gastric lymphoma].

UNLABELLED: Mucosa-associated lymphoid tissue (MALT) conception has been extensively developing for last 20 years. THE AIM: The aim of this work was to elaborate clinico-morphological and immunohistochemical criteria of gastric MALT-lymphomas and to differentiate them from another with similar histology. MATERIALS AND METHODS: Between 1983 and 2007, 704 patients with diagnosis of extranodal lymphoma were observed in Russian Cancer Research Center. The work included biopsy and postoperation samples from 115 patients with primary gastric lymphoma, who were observed in Russian Cancer Research Center since 1995. On presented material with primary lymphomas were elaborated morphological criteria of MALT-lymphoma diagnosis for gastrobiopsy, based on histological, immunohistochemical and genetic examination. Also were devised differential diagnostic criteria of MALT-lymphoma. RESULTS: Follow morphological signs were estimated: cell composition, atypia of neoplastic elements, presence of plasmocellular differentiation of lymphoid cells, expression of plasmocytary infiltration, lymphoepithelial lesion and reactive lymphoid follicles with or without colonization, presence of blasts. So, in 35.2% cases part of neoplastic elements had the aspect of monocytoid B-lymphocytes. In the most of observations were revealed plasmatic cells. More often they were under integumentary epithelium as massive layer (46.47%), more rare they were scattered in superficial sections of lamina propria among cells of leukocyte row (39.43%). Lymphoepithelial lesions (LELs) are aggregates from three and more marginal zone cells, destroyed epithelium of glands, were revealed in half of cases. In 17.14% cases were ("blast") LELs, generated by large blasts. For reactive process T-lymphocytes predominate over B-lymhpocytes in the lymphocellular infiltrate, or T-lymphocytes and B-lymhpocytes are in equal ratio. The next important sign is coexpression T-cell marker CD43 on neoplastic B-cells. Cases of MALT-lymphoma with t(11; 18) are resistant to the antihelicobacter therapy. CONCLUSION: The most informative morphological, immunohistochemical features were ascertained as in diagnosis, as in differentiation with another neoplasms with similar morphology and reactive lymphoid infiltrates.

[Endoscopic criteria for diagnosis of various macroscopic variants of non-Hodgkin's gastric lymphoma].

UNLABELLED: BACKGROUND; Many investigators account that a stomach is the most often localization of gastrointestinal lymphomas. But endoscopic semiotics and diagnostic of those lesions is elaborated insufficiently. PURPOSE: The purpose of our investigation was working out of non-Hodgkin's gastric lymphoma endoscopic criteria. MATERIALS AND METHODS: We examinated 250 patients with gastric lymphoma, from those primary and secondary lesions were in 160 (64%) cases and 90 (36%) cases, respectively. All patients was performed standard videoendoscopy, which included magnified endoscopy with NBI (Narrow Band Imaging), followed by chromoendoscopy with indigocarmine (0.4% solution) and EUS. Diagnosis of lymphoma was confirmed by morphology and immunohistochemistry. RESULTS: According to our observations gastroenterological pathology duration to diagnosis of tumor was very variable: diagnosis was established during first 3 months in 30.6% cases (49 patients), during 6 month in 18.1% cases (29 patients), from 6 to 12 months in 15.6% cases (25 patients). Separately should was noted, that almost in one third cases primary gastric lymphoma was diagnosed after one year. Macroscopic form of gastric tumor was represented by follow variants: exophytic--22 cases (8.8%), infiltrative--54 cases (21.6%), ulcerous--37 cases (14.8%), infiltrative-ulcerous--71 cases (28.4%), similar to gastritis--36 cases (14.4%), mixed--30 cases (12%). The second endpoint of our work was detection of macroscopic features depending on morphological variant of lymphoma. Analysis of represented data demonstrated prevalence similar to gastritis form (33.4%) for MALT-lymphoma, infiltrative-ulcerous form as for diffuse large-cell B-cell lymphoma of MALT-type, as for diffuse large-cell B-cell lymphoma--45.0% and 41.1%, respectively. Infiltrative form was more often in group of patients with follicular lymphoma--31.8%, and ulcerous form predominated for Burkett's lymphoma--60.0%. CONCLUSION; Were established the most informative endoscopic criteria for diagnosis non-Hodgkin's gastric lymphoma.

[Non-Hodgkin's lymphomas of the stomach: modern state of the problem].

In article epidemiological aspects NHL are shined, the basic attempts of kliniko-morphological ordering lymphomas are described, opened them morphimmunological aspects. As clinical value of various histologic classifications of NHL is shined. On the basis of studying of all displays of NHL are noted by the most significant factors of the adverse forecast, taken as a principle international prognostics index, risks of early progressing of NHL are described also. Results of 5-year-old survival rate reveal at NHL depending on morphimmunological variant.

[Endosonographic criteria for indolent and aggressive non-Hodgkin's lymphoma of the stomach].

UNLABELLED: At the present stage use only standard visual endoscopy and a radiological method of research of a pathology of a stomach does not meet the requirements of oncologists. In spite of the fact that these techniques continue to remain base and prime in inspection of a digestive tract, the leading part in specification of character of pathology of GI tract is taken now endosonography method. A research objective: to establish endoscopic ultrasonic criteria of diagnostics indolentics and aggressive NHL of stomach. MATERIALS AND METHODS: For studying of possibilities endosonography in diagnostics NHL of a stomach 46 patients have been analysed, during the period since 2005 for 2009 to all patients after videogastroscopy was carried out endoscopic scanning, and the tumour biopsy further was made. RESULTS: Are defined by us endosonography criteria NHL of a stomach: the tumor starts with deep layers mucous and submucosal layer, extends mainly on submucosal layer, it is marked multicentrial defeats, echoic tumors is always lowered or heteroechoic with hypo echoic inclusions. On the basis of this data by us are defined endosonography criteria various morphoimmunological variants of NHL of a stomach. Estimating possibilities endoscopic ultrasonic diagnostics it has been revealed that its diagnostic accuracy makes 87.7%. In 84.9% at use EUS it is possible to assume authentically presence lymph proliferative process of a stomach and in 94.7% endosonography will allow to exclude authentically pathological process in a stomach.

[Endoscopic resection of mucosal and submucosal stomach layers as the diagnostic and medical procedure in oncology].

Owing to introduction in a daily practice of modern medical technologies there was real improvement of duly diagnostics of early forms of a cancer of a gastroenteric path. In this connection interest to endoscopic methods of its treatment has increased. According to the world literature, parameters of a radical resection of a mucous membrane of a stomach in occasion of early cancer vary in a range of 75-98% depending on the macroscopical form of growth and the sizes of a tumors. There is one more very important parameter on which efficiency of a method EMR depends, it is the fact of use of a technique of removal of pathological formation by the uniform block or by parts. As us, with the purpose of all-round studying opportunities of a EMR and ESR was carried out as diagnostic procedure at infiltrative forms of a cancer and lymphomas of stomach.Thus, the purpose of our research is studying true value and the importance of application of EMR and ESR, as with the purpose of specifying diagnostics, and a curative method in oncology.

[Autofluorescence diagnosis of malignant tumors of the head and neck]. / Autofliuorestsentnaia diagnostika zlokachestvennykh opukholei golovy i shei.

A new method for diagnosing human malignant tumors is dealt with, which is based on fluorescence of malignant neoplasms and their adjacent normal tissue. To measure the fluorescence spectra, a fiber optic system and a multi-channel optic spectral analyser have been designed. While analysing the resultant spectra, a greater fluorescence excess was observed in the red wave band in the tumors than in normal tissue. Further investigations are required in order to use the method in question in clinical diagnosis.

[Endoscopic studies in lymphosarcoma in children]. / Endoskopicheskie issledovaniia pri limfosarkome u detei.

The value of various endoscopic methods in diagnosing lymphosarcoma was assessed in 149 suspects aged 3-14 years. Fiberscopy of the upper digestive tract was performed in 130 children of whom 43 revealed lymphosarcoma in Waldeyer's ring whereas in 87 lymphoid hyperplasia was detected. Laparoscopy was carried out in 17 children, esophagogastroduodenoscopy--2 and colonoscopy--in one case Endoscopic methods proved to be of high diagnostic value, easily available and safe for examination of children suspected for lymphosarcoma.

[Diagnostic and therapeutic tactics in gastric polyps]. / Diagnosticheskaia i lechebnaia taktika pri polipakh zheludka.

During examination and dynamic endoscopic follow-up of 151 patients suffering from polyps of the stomach of various histological structure with various degree of epithelial dysplasia or without it, different types of treatment were undertaken in 61 patients. The results of the treatment are analysed, the efficacy of different methods of biopsy of polypoid structures and alternative methods of treatment of patients with benign and malignant polyps are evaluated, and the recognition of endoscopic polypectomy as a diagnostic and therapeutic intervention is substantiated.

[Endoscopic laser recanalization in the chemo- and radiotherapy of stenosing cancer of the esophagus]. / Endoskopicheskaia lazernaia rekanalizatsiia v khimioluchevom lechenii stenoziruiushchego raka pishchevoda.

The authors analyze the results of endoscopic laser recanalization in 11 patients with stenosing esophageal carcinoma, whose mean age is 61 years. The tumor was located in the upper thoracic portion of the esophagus in 3 patients, in the middle thoracic portion in 6, and in the lower thoracic portion in 2 patients. The diagnosis of carcinoma was morphologically verified. The length of the esophagus involvement was estimated by x-ray data and varied from 5 to 12 cm and longer. Endophytic form predominated--it was diagnosed in 5 patients. The technique of endoscopic laser recanalization by means of Raduga-1 unit with neodymium alumo-yttrium garnet laser as the source of irradiation is described. The method was specified with consideration for the type of tumor growth. The patients were kept on parenteral nutrition during the treatment session. Three-five days after endoscopic laser destruction long-distance open-field gamma-beam therapy was administered to 10 patients and polychemotherapy to 9 of these. After laser destruction dilatation of the stenosed portion of the esophagus from 0.2-0.6 to 1.0-2.0 cm was recorded in 10 patients. Complete regression of the tumor resultant from laser destruction and chemoradiotherapy was achieved in 5 patients, partial regression in the rest 5. The patients were followed up for 5-12 months. No recurrences were recorded in patients with complete regression of the tumor; the process progressed in 3 cases with partial regression. Studies on improvement of recanalization technique, specification of indications for and contraindications against this treatment modality are in progress.

[Diagnosis of primary tumors of the trachea]. / Diagnostika pervichnykh opukholei trakhei.

The paper presents 10-year results of endoscopic examinations which have been performed of late in the Endoscopy Department of the All-Union Cancer Research Center. Altogether 36 patients with primary tracheal tumors (PTTs) were evaluated. The study of PTTs endoscopic pattern suggested the conclusion on feasibility of visual differential diagnosis of various tumors and assessment of the tumor spread along the bronchial tree.

[Laparoscopic diagnosis of neoplastic diseases in ambulatory patients]. / Laparoskopicheskaia diagnostika opukholevykh zabolevanii u ambulatornykh bol'nykh.

The article deals with the results of the first experience in using laparoscopy for establishing the diagnosis of neoplastic diseases of the abdominal organs in 32 patients in an out-patient clinic. The contraindications were determined and some organizational measures in conducting laparoscopy in this group of patients were mapped out. A method is suggested for closing the operative wound after laparoscopy with sutures applied through all layer under laparoscopic control. The authors consider strict selection of patients for laparoscopy in out-patient clinics to be expedient.

[Endoscopic evaluation of the therapeutic results in patients with small cell lung cancer]. / Endoskopicheskaia otsenka rezul'tatov terapii bol'nykh melkokletochnym rakom legkogo.

The analysis of the data of 352 fiber bronchoscopies performed in 142 cases of small-cell lung cancer before, in the course and after chemotherapy or chemoradiation treatment makes a case for complex application of X-ray and endoscopic procedures since the data on diagnosis and response to treatment obtained under the separate use of either procedure agreed in 67.7% and 80.3% of cases only.

[The probability of malignant degeneration of stomach polyps]. / Veroiatnost' malignizatsii polipov zheludka.

A retrospective analysis of the endoscopic diagnostic data on 151 cases of gastric polyps of various histological structure was carried out. A relationship between the risk of malignant transformation of gastric polyps, on the one hand, and their histology, presence and degree of dysplasia, on the other, was established. Epithelial dysplasia, in pronounced degree included, was observed in 33.7% of patients with hyperplastic polyps and in all cases of gastric adenoma. Epithelial dysplasia of hyperplastic polyps was mild or moderate in most cases while that of adenomatous polyps was moderate or grave. Gastric cancer as a consequence of malignant transformation of polyps was detected in 15 (9.9%) patients (hyperplastic polyps--2; adenomatous polyps--13). No objective endoscopic criteria for establishing the risk of polyp transformation were developed. Grave epithelial dysplasia, i.e. precancerous lesions in the gastric mucosa, may be suggested as such criterion. Moderate or grave dysplasia of the polyp epithelium should be considered in forming the group at risk first and foremost.

[Epithelial dysplasia and cancer of the stomach]. / Epitelial'naia displaziia i rak zheludka.

Relationships between chronic gastric diseases and gastric cancer are discussed. Mucosal epithelial dysplasia may be regarded as the most reliable sign of increased risk of gastric cancer. Endoscopy with biopsy is the principal method for the assessment of the dysplasia-cancer relationship. A retrospective study of histologic preparations and smear imprints from gastric biopsy specimens and operative samples, obtained from 292 patients with chronic gastritis, gastric ulcers, gastric polyps and polyposis, and conditions following gastric resection for nontumorous diseases and cancer (group 1) and 80 patients with verified gastric cancer (group 2), is reported. In both groups, there was mucosal dysplasia of varying markedness. Endoscopic monitoring revealed gastric cancer in 48 first-group patients. Gastric cancer, combined with dysplasia, was detected in 128 patients from both groups, its early stages, in 37 of those. Convincing evidence in favor of a relationship between dysplasia and cancer is presented.

[The role of endoscopic study in the diagnosis of precancerous gastric pathology and identification of a risk group]. / Rol' éndoskopicheskogo issledovaniia v diagnostike predopukholevoi patologii zheludka i formirovanii gruppy riska.

The results of endoscopic diagnosis and case follow-up of 686 patients with precancerous gastric conditions usually identified as a risk group (chronic gastritis, polyps, peptic ulcer, conditions following distal stomach resections) have shown that in patients with symptoms of epithelial dysplasia of gastric mucosa indices of cancer detectability significantly exceeded those in similar pathological conditions without symptoms of epithelial dysplasia. They were 22.0 +/- 2.5% and 2.5 +/- 0.8%, respectively; indices of stage I stomach cancer detectability were 9.9 +/- 1.8% and 0.2 +/- 0.2%, respectively. Patients with precancerous stomach diseases with moderate and severe epithelial dysplasia found in their gastric biopsies, should be attributed to a risk group, and these changes of gastric mucosa must be regarded as the main criterion for the identification of such a group.