Velicković D, Sabljak P, Ebrahimi K, Bjelović M, Stojakov D, Nenadić B, Spica B, Sljukic V, Pesko P
Centar za hirurgiju jednjaka, I Hirurska klinika, Institut za bolesti digestivnog sistema, KCS, Beograd.
Acta Chir Iugosl. 2007;54(1):131-4. doi: 10.2298/aci0701131v.
Primary gastric lymphomas are of the extranodal non-Hodgkin type. The gastrointestinal tract is the most common site of extranodal non-Hodgkin lymphomas and accounts 30-45% of all extranodal lymphomas. Gastrointestinal lymphomas occurs in the stomach in 55-70% of cases. Primary gastric lymphoma is relatively rare tumor accounting 1-7%, of all gastric malignancies. An increased incidence has been documented recently. The median age of diagnosis is approximately 60 years old, and disease affects an equal number of men and women. The initial symptoms may be vague and nonspecific leading to delayed establishment of diagnosis up to several years. Many patients came down late with advanced disease and complications such as upper gastrointestinal bleeding. Twenty to thirty percent may present with occult bleeding or hematemesis et melena while gastric obstruction and perforation are less common. Gastric bleeding can also occur as a complication of chemotherapy. The incidence of gastric bleeding in patients receiving chemotherapy is up to 11%. In most cases surgical resection is necessary to achieve hemostasis. Given the rate of surgical complications, especially gastric bleeding, there is still an important role for surgeon in the multimodal treatment of patients with primary gastric lymphoma.
原发性胃淋巴瘤属于结外非霍奇金淋巴瘤类型。胃肠道是结外非霍奇金淋巴瘤最常见的发病部位，占所有结外淋巴瘤的30% - 45%。胃肠道淋巴瘤55% - 70%发生于胃部。原发性胃淋巴瘤是相对罕见的肿瘤，占所有胃恶性肿瘤的1% - 7%。最近有文献记载其发病率有所上升。诊断时的中位年龄约为60岁，男性和女性患病人数相等。初始症状可能模糊且不具特异性，导致诊断延迟数年。许多患者就诊时病情已进展至晚期，并出现上消化道出血等并发症。20% - 30%的患者可能表现为隐匿性出血或呕血及黑便，而胃梗阻和穿孔则较少见。胃出血也可能作为化疗的并发症出现。接受化疗的患者胃出血发生率高达11%。在大多数情况下，需要进行手术切除以实现止血。鉴于手术并发症的发生率，尤其是胃出血，外科医生在原发性胃淋巴瘤患者的多模式治疗中仍发挥着重要作用。
