RESUMEN
Primary lymphoma of the stomach (PLS) is an uncommon neoplasm, accounting for up to 8 per cent of all malignant neoformations with this particular localization. Its development is linked to the so-called mucosa associated lymphoid tissue (MALT), wherefrom its denomination--MALT lymphoma--is derived. In the stomach, under ordinary conditions, it is nonexistent, and in most of the cases it is acquired through infection with H. pylori. In a prevailing percentage of PLS it is a matter of B-cell lymphoma with low-degree malignancy. T-cell lymphomas occur sporadically, as well as primary Hodgkin's lymphoma which is exceptionally rare. Histologically the B-cell lymphoma reiterates the structural pattern of Peyer's plaque prototype, involving also a number of non-neoplastic components. The most distinguishing cells are reminiscent of centrocytes (centrocyte-like cells--CCL)--a term adopted for all MALT-lymphoma cases. They vary considerably in terms of cytological appearance, and may even bear resemblance to Hodgkin's and Sternberg's cells. Signet-ring lymphomas, known in several variants, are also by no means ruled out. Immunohistochemical typing presupposes a definitive diagnosis being made. In case of immunosuppression (transplantation, HIV-infection) the risk of B-cell lymphomas development augment, and what is more, most of them associated with Epstein-Barr viruses characterized by a substantially more aggressive course and poor prognosis.
Asunto(s)
Linfoma de Células B de la Zona Marginal/diagnóstico , Neoplasias Gástricas/diagnóstico , Humanos , Metástasis Linfática , Linfoma de Células B de la Zona Marginal/patología , Ganglios Linfáticos Agregados/patología , Estómago/patología , Neoplasias Gástricas/patologíaRESUMEN
The study covers 108 patients with stomach resection (Billroth II), performed over a period of six years (1988-1993). Endoscopic and biopsy findings are described. Carcinoma of the gastric stump is established in 16 cases (14.8 per cent), high degree epithelial dysplasia-in six (5.5 per cent), and signs of acute or chronic anastomositis, superficial of atrophic gastritis, intestinal metaplasia, lipid islands and single hyperplastic polypoid lesions are present in all cases. Dysplasia III degree and carcinoma in the gastrojejunal junction are observed in the older age group with 10-15 years postoperative follow-up study. Patients with stomach resection should undergo check-ups and multiple biopsies at 3-5 years intervals, especially those with high-degree epithelial dysplasia.