Colecchia G, Saragani C, Det Cimmuto P, Astolei A, Saggese N, Prosperi A, De Berardinis O
Divisione di Chirurgia Generale, Ospedale Civile-S Liberatore-Atri (Teramo).
Minerva Chir. 1996 Dec;51(12):1061-5.
The authors report their experience regarding primary gastric lymphoma. The series presented consists of 5 cases: a correct preoperative diagnosis of primary gastric lymphoma was made in one case, whereas pseudolymphoma was hypothesised in a second patient. The remaining three cases were all maltomas. After examining the histological characteristics and classification of primary gastric lymphomas, the authors underline the importance of an early preoperative diagnosis of gastric lymphoma. The repeated use of endoscopic techniques with biopsy compared to radiological examination increases the possibility of diagnosing lymphoma from 20% to 85%. The success rate is further increased if ultrasonic endoscopy is used instead of endoscopy alone, thus making it possible to achieve a 97% diagnostic success rate. The authors then emphasise the fundamental role played by surgery in the treatment of gastric lymphoma. Depending on the depth of neoplastic infiltration, the dimensions of the neoplasia and its multifocality, in localised forms of the antrum (IE, IIE with a low degree of malignancy) surgery consists of resection with partial gastrectomy, provided the resection margins are undamaged, or total gastrectomy in those forms involving the fundus and body of the stomach.
作者报告了他们关于原发性胃淋巴瘤的经验。所呈现的病例系列包括5例:1例术前正确诊断为原发性胃淋巴瘤,而第2例患者推测为假性淋巴瘤。其余3例均为黏膜相关淋巴组织淋巴瘤。在研究了原发性胃淋巴瘤的组织学特征和分类后,作者强调了胃淋巴瘤术前早期诊断的重要性。与放射学检查相比,反复使用内镜技术并进行活检可将淋巴瘤的诊断可能性从20%提高到85%。如果使用超声内镜而非单纯内镜检查,成功率会进一步提高,从而有可能达到97%的诊断成功率。作者随后强调了手术在胃淋巴瘤治疗中所起的关键作用。根据肿瘤浸润深度、肿瘤大小及其多灶性,对于局限性胃窦部病变(即低恶性度的IE、IIE型),若切缘未受侵犯,手术方式为部分胃切除;对于累及胃底和胃体的病变,则行全胃切除。