MORPHOLOGY AND STAGING OF PRIMARY GASTRIC NON-HODGKIN-LYMPHOMA (MALT)IN HYDRO-CT IMAGING

Purpose: Evaluation by hydro-CT in diagnosing and staging of primary n on-Hodgkin lymphoma of the stomach (MALT). Material and methods: 15 pa tients with MALT lymphoma underwent imaging by hydro-CT (helical CT sc anning optimised for parenchymal and vessel contrast with distension o f the gastric wall by water). The CT scans were evaluated for the site , morphology, extent and contrast enhancement of gastric lymphoma; in addition, the number and location of abdominal lymph nodes were examin ed. The results of CT imaging were compared with the findings at endos copy + biopsy and endosonography and in case of gastrectomy also with the histopathological results. Results: All lymphomas were correctly d iagnosed and were mostly located in the distal parts of the stomach. M ALT lymphoma typically grew submucosally, infiltration of the mucosa w as rare. Most tumours showed marked contrast enhancement of the mucosa and poor enhancement of the submucosa. Hydro-CT and endosonography ha d similar accuracies in respect of staging of compartment I and II lym ph nodes. Staging of distant nodal groups was more accurate by hydro-C T. Conclusion: Hydro-CT is non-invasive and may be used for diagnosis and staging of primary gastric lymphoma with a typical morphology of g astric lymphoma. Hydro-CT may be regarded as complementary to endosono graphy and is well suited for the initial diagnosis of gastric lymphom a as well as for the diagnosis of recurrent tumour.