Linfoma gástrico primario. Características clinicopatológicas de una serie mexicana

SUMMARY Objective: To analyze pathologic and clinical features in patients with primary gastric lymphoma (PGL) in a reference hospital in Mexico City, and to evaluate the variety of treatments chosen. Methods: Patients with primary gastric lymphoma between 1975 and 2000. Those with histological diagnosis of primary gastric lymphoma confirmed by endoscopic biopsy or gastrectomies were eligible for inclusion in the study. The study was retrolective. Results: Forty-two patients (21 M, and 21 F) with an average age of 57 years (between 20 and 80 years). The major clinical findings were no weight loss in 31 patients (73%), abdominal pain in 24 patients (57%), gastrointestinal pair in 19 patients (45%), and early satiety in 15 patients (36%). The endoscopic findings were gastric folds in 21 (50%), thickening of gastrics folds in 13 (31%) and tumor in eight patients (19%). We found H pylori in 14 of 16 endoscopic biopsies (87%). High grade lymphomas were found in 29 patients (69%) and low grade lymphoma in 13 (31%). The clinical stage according to the Staging Classification from the Fifth International Conference on Malignant Lymphoma (1993) was 15 patients in stage I (36%), 14 patients in stage II1(33%). Five patients in stage IV (12%), six patients in stage IIE (14) and one patient in stages II and II2 (2%). The treatment chosen before 1990 was surgery with or without chemotherapy no matter the grade of malignancy, in contrast with the later decade in which solely eradication of H pylori was successfully to cure the disease. In high grade lymphomas, treatment was surgery and chemotherapy for reviewing the study, most patients were alive and without disease. Conclusions: In the study, most lymphomas were localized in the stomach of perigastric limph nodes. The most frequent clinical stages were stages I and II1(36 and 33%, respectively), and their response was successful to all treatments even though most patients were high graded and treated differently.