Klaiber H, Sulser H, Rüttner J R, Kobler E, Deyhle P
Schweiz Med Wochenschr. 1979 May 5;109(18):668-75.
A retrospective analysis is presented of 38 cases of malignant lymphomas of the stomach, 20 of the reticulum cell type, 6 lymphoblastic, 6 lymphocytic and 4 mixed forms. Two patients had a primary Hodgkin's malignant lymphogranuloma. A follow-up was obtained for 35 patients. There proved to be no significant difference between the symptomatology of carcinoma and lymphoma of the stomach. In patients with lymphomas only signs of stenosis were missing, although the majority of the tumors were located in the antrum. As a consequence of the extreme tendency of the lymphomas to exulcerate (89%), the mean duration of symptoms of 21/2 months (patient's delay) is shorter than that for carcinomas. Malignant lymphomas of the stomach are very difficult to identify as such by radiology and endoscopy, because of their uncharacteristic macroscopic appearance. The best diagnostic method has proved to be endoscopic wire-loop biopsy, which serves to obtain adequate material for histology. An unexpected finding was that at the time of operation half of the patients had clinical stage I E. This indicates that lymphomas remain limited to the stomach longer than carcinomas do. The prognosis depends on both histological type and clinical stage. It is somewhat better than that of nodal malignant lymphomas. The 5-year survival rate of all cases with malignant lymphoma of the stomach is 31%.
本文对38例胃恶性淋巴瘤进行了回顾性分析，其中20例为网状细胞型，6例为淋巴母细胞型，6例为淋巴细胞型，4例为混合型。2例患者为原发性霍奇金恶性淋巴肉芽肿。对35例患者进行了随访。结果表明，胃癌与胃淋巴瘤的症状学之间无显著差异。在淋巴瘤患者中，仅缺少狭窄体征，尽管大多数肿瘤位于胃窦部。由于淋巴瘤极易发生溃疡（89%），其症状平均持续时间为2个半月（患者延误），较胃癌为短。胃恶性淋巴瘤因其宏观表现无特征性，通过放射学和内镜检查很难确诊。最佳诊断方法是内镜钢丝圈活检，可获取足够的组织学材料。一个意外发现是，手术时半数患者处于临床ⅠE期。这表明淋巴瘤局限于胃内的时间比癌更长。预后取决于组织学类型和临床分期。其预后比淋巴结恶性淋巴瘤稍好。胃恶性淋巴瘤所有病例的5年生存率为31%。
