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Updated: Jun 20, 2026
Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia
Published on: February 16, 2024
Primary low-grade and high-grade gastric MALT-lymphoma presentation
Angelo Zullo1, Cesare Hassan, Alessandro Andriani
1Gastroenterology and Digestive Endoscopy, Haematology,Nuovo Regina Margherita Hospital, La Sapienza University, Rome, Italy. zullo66@yahoo.it
Goal:
To assess the clinical and endoscopic presentation of primary gastric lymphoma.
Background:
Remission rate and long-term survival in patients with gastric lymphoma mainly depend on disease stage at diagnosis. Series reporting clinical and endoscopic presentation of gastric lymphoma are generally small and heterogeneous.
Study:
Systematic review with pooled-data analysis assessing clinical and endoscopic presentation of primary gastric lymphoma.
Results:
Data regarding 2000 patients were collected. Overall, males were slightly more prevalent, alarm symptoms were absent in near half of the patients, lymphoma was diagnosed in a stage >I in one-third of the patients, and Helicobacter pylori infection was present in 88.8% of considered patients. At endoscopy, the ulcerative type was the most frequent presentation, although low-grade lymphoma was diagnosed on normal/hyperemic gastric mucosa in 9% of cases. Patients with high-grade lymphoma presented alarm symptoms (anemia and/or melena and/or hemorrhage, persistent vomiting, weight loss), an exophytic or ulcerative lesion, a stage III-IV, and a H. pylori negative status more frequently than low-grade lymphoma cases.
Conclusions:
Our pooled-data analysis showed that gastric lymphoma is still disappointingly diagnosed in an advanced stage in a large number of patients. This is probably due to presence of nonspecific symptoms at initial clinical presentation and/or a normal appearing mucosa at endoscopic observation in the early stages.
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