COMPARATIVE ENDOSCOPIC STUDY OF PRIMARY GASTRIC LYMPHOMA VS GASTRIC-CARCINOMA

The endoscopic records of 56 patients with primary gastric lymphoma an d 120 patients with gastric adenocarcinoma (matched for age and sex) w ere compared with respect to site, extent, and type of tumor by endosc opy and biopsy results. Diagnosis of lymphoma was suspected on the bas is of gross endoscopic appearance in 30 patients with 96% sensitivity. The endoscopic findings that achieved statistical significance in fav or of lymphoma were extensive disease involving whole stomach, proxima l stomach involvement, extension of tumor into duodenum, and the prese nce of volcano crater-like ulcers on polypoid lesions. Endoscopic biop sies were positive for lymphoma in 92% patients. Immunoperoxidase stai ning for leucocyte common antigen was positive in all the 24 patients with lymphoma where it was performed. We conclude that lymphoid origin of the stomach tumor may be suspected in one-half of the cases of pri mary gastric lymphoma by gross endoscopic findings. Multiple endoscopi c biopsies are safe and highly sensitive and specific in the diagnosis of primary gastric lymphoma. (C) 1994 Wiley-Liss, Inc.