Sanfilippo G, Aprile G, Magnano A, Pecorella S, Virgilio C, La Malfa M
Minerva Med. 1983 Mar 24;74(12):595-9.
The Authors have diagnosed by endoscopy and biopsy 33 primitive gastric lymphomas (6,7% of all malignant gastric tumors diagnosed over 6 years). Endoscopic observation alone diagnosed lymphoma in 63,6% of the cases. Exact diagnosis was made in all cases of polymorphic or multi-ulcerated lesions. The observation of a single ulcerated or ulcero-vegetative lesion (30,3%) suggested diagnosis of carcinoma. A false negative diagnosis of inflammatory pathology was made in 6,1% of the cases. Biopsy gave correct diagnosis in 69,7%. Highest percentage of positive biopsies was obtained in both single and multiple ulcerated lesions (88,2%), while infiltrating lesions provided positive biopsies in 50% of the cases. Endoscopy together with biopsy gave correct diagnosis in 90,9%. In fact, endoscopic diagnosis of lymphoma was confirmed after resection in 7 cases even if the individual biopsies showed superficial gastritis. The Authors believe that correct endoscopic study of primitive gastric lymphomas is based on knowledge of the various morphologies of the tumor and on a systematic performance of a large number of biopsies of both the lesions and surrounding mucosa.
作者通过内镜检查和活检诊断出33例原发性胃淋巴瘤(占6年期间诊断出的所有恶性胃肿瘤的6.7%)。仅通过内镜观察诊断出淋巴瘤的病例占63.6%。在所有多形性或多发溃疡病变的病例中均做出了准确诊断。观察到单个溃疡或溃疡-赘生性病变(30.3%)提示为癌。6.1%的病例对炎症性病变做出了假阴性诊断。活检的正确诊断率为69.7%。在单个和多个溃疡病变中活检阳性率最高(88.2%),而浸润性病变的活检阳性率为50%。内镜检查与活检相结合的正确诊断率为90.9%。事实上,7例病例在切除术后证实了淋巴瘤的内镜诊断,尽管个别活检显示为浅表性胃炎。作者认为,对原发性胃淋巴瘤进行正确的内镜研究基于对肿瘤各种形态的了解以及对病变和周围黏膜进行大量活检的系统操作。