[Endoscopic biopsy diagnosis of malignant lymphoma of the stomach and early stomach lymphoma].

From 1978 to 1988 a malignant lymphoma of the stomach was diagnosed endoscopic-bioptically in 47 patients. In 41 patients it was a primary gastric lymphoma, in 6 a generalized lymphoma. In 20 cases an advanced gastric lymphoma was present which was diagnosed endoscopic-bioptically without problems. In 27 cases, however, lymphomas showed polymorphous lesions which did not look tumorous. In such cases the lymphomas were found in an early stage and bioptic verification was difficult. On an average three bioptic series were needed for histological proof. In 16 lymphomas of this group the malignant infiltration was limited to mucosa/submucosa on operative resection specimens ("early gastric lymphomas") The endoscopic appearance of these early lymphomas was: thickening mucosa-folds (2 cases), extended areas of "regenerative mucosa" and granular pattern (6 cases), mainly multiple irregular ulcerations (8 cases). The above mentioned endoscopic findings are strongly suspected for an early gastric lymphoma and should be clarified by, if needed repeated, bioptic series.