Primary gastric lymphoma: incidence and role of surgery

The histological subgroups of primary gastric tumours presenting to one surgical unit over two successive six year periods were analysed and the therapeutic value of gastric resection assessed. An increased incidence of gastric lymphoma (13% relative to 5%) occurred in the second six year period. This increase could not be attributed to improved morphological or histochemical techniques. The diagnosis of lymphoma was confirmed preoperatively in 13 (94%) of the 14 patients by a combination of multiple endoscopic biopsies and brush cytology. Five of the six patients who underwent a potentially curative resection are tumour free at a mean follow-up of four years. Histological grading, whether high or low, had no bearing on survival. Gastric lymphoma is increasing in incidence and should be considered in the evaluation of gastric tumours as surgical resection at present offers the best prospect of long term survival.