The diagnosis of early gastric lymphoma

In analogy to the early carcinoma of the stomach, early gastric lymphoma is defined as a tumour with a maximum depth of infiltration extending into the submucosa. Among 94 consecutive gastric surgical specimens investigated, 45 (47.9%) early lymphomas were diagnosed. Macroscopically, most of these tumours present a non-uniform "variegated picture". There appears to be no relationship between the largest transversal diameter of the gastric lymphoma and its depth of penetration. In contrast, a statistically significant relationship was detected between the degree of malignancy and the depth of infiltration. Involvement of the regional lymph nodes by lymphoma is increased significantly with a high degree of malignancy and greater depths of infiltration, while the incidence of lymph follicles decreases. An analysis of the morphology of the surgical specimens reveals that - in common with early cancer of the stomach - early lymphomas, too, pass through a "malignant cycle". Depth of infiltration and degree of malignancy also have an influence on the number of endoscopic/biopsy examinations necessary to permit a definitive diagnosis of lymphoma.