[Primary lymphoma of the stomach. An interdisciplinary challenge]

Non-Hodgkin-lymphomas of the stomach are mostly of mucosal origin. The lymphoma derives from the acquired lymphatic tissue due to an infection with helicobacter pylori. Beside the grade of malignancy (low/high grade) the extent of the disease is the basis for therapy. It can be limited to the stomach and the lymph node compartments I and II or disseminated to both sides of the diaphragm. Therefore, pre-therapeutic diagnostic procedures have to cover all these localisations including the bone marrow. In case of a tumor limited to the stomach and of low grade malignancy an eradication therapy is the treatment of choice. More advanced tumors, but only involving stomach and lymph node compartments I and II, should be treated by subtotal or total gastrectomy plus lymphadenectomy according to the gastric cancer standards (D2). After R0-resections no adjuvant radio- or chemotherapy is necessary. R1/2 resections require radio- and/or chemotherapy which are the treatment of choice in a priori advanced stages and/or high grade lymphomas. The total 5 year survival rate is about 60-70%. Gastric lymphomas are an outstanding example of interdisciplinary disease management.