Primary gastric lymphoma

Primary gastric lymphoma is the most frequent non-Hodgkin's lymphoma (NHL) of extranodal origin (25%). It accounts for 5% of all NHL and 4% of primary gastric malignancies. Recent studies suggest its origin from B-cell immune system. The majority of these tumors are high-grade centroblastic and immunoblastic subtype. The extent of disease is by far the most important guide to prognosis. Patients with gastric lymphoma usually recur in the gastrointestinal tract, but one-half of those recurring in abdomen also have tumor spread to extra-abdominal sites. Gastrectomy as a single treatment modality cures about one-third of patients with gastric lymphoma. The role of adjuvant therapy both in terms of radiotherapy and chemotherapy is not sufficiently known. In advanced stage when chemotherapy is indicated, CHOP combination seems to be appropriate in favorable prognostic situation, whereas aggressive third-generation combinations should be used for unfavorable cases.