Extension of gastric lymphoma into the esophagus and duodenum

In 81 patients with gastric lymphoma, spread of tumor beyond the stomach was analyzed based on radiographs and medical records. Tumor extension into the esophagus was present in 10% of patients, and spread across the pylorus into the duodenal bulb was seen in 33%. When the gastric fundus alone was involved, transcardial extension was seen in four of 10 patients, and when only the antrum was involved, transcardial extension was seen in four of 10 patients, and when only the antrum was involved, transpyloric extension was present in six of seven patients. One-third of the patients with gastric lymphoma secondary to disease in adjacent structures had contiguous involvement of the esophagus or duodenum. This study shows that transcardial extension cannot be used to differentiate gastric lymphoma from adenocarcinoma, and its confirms the frequent occurrence of transpyloric tumor extension in patients with gastric lymphoma.