Lymphoma of the stomach.

A retrospective review revealed 17 lymphomas in a 25-year period (1960-84). Presenting features did not allow differentiation from carcinoma. Preoperative diagnosis was made in 3 patients by endoscopic biopsy. Treatment included apparent complete resection of 12 patients. Incomplete removal following biopsy with or without a drainage procedure was performed on five patients. Radiation therapy was used on ten patients and chemotherapy was used on three patients. There were three 5-year survivors and four others with survival greater than 2 years. All patients surviving more than 2 years had apparent complete resection while five patients also had radiation. One also had chemotherapy. Analysis of our patients with review of other series suggests complete resection with adjacent nodes to be the best approach. Appropriate node sampling, liver biopsy, and removal of the spleen if it appears clinically involved should be done. Postoperative radiation and/or chemotherapy may be indicated only when apparent complete resection is not feasible.