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Radiographic findings of primary B-cell lymphoma of the stomach: low-grade versus high-grade malignancy in relation to the mucosa-associated lymphoid tissue concept.

Authors
Park, MS; Kim, KW; Yu, JS; Park, C; Kim, JK; Yoon, SW; Lee, KH; Ryu, YH; Kim, H; Kim, MJ; Lee, JT; Yoo, HS
Citation
AJR. American journal of roentgenology, 179(5):1297-1304, 2002
Journal Title
AJR. American journal of roentgenology
ISSN
0361-803X1546-3141
Abstract
OBJECTIVE: We undertook this study to assess how well double-contrast radiography and CT allow radiologists to differentiate low-grade from high-grade mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach.



MATERIALS AND METHODS: We retrospectively reviewed the upper gastrointestinal radiographs and contrast-enhanced CT scans of 57 patients with pathologically proven primary gastric lymphoma (low-grade [n = 29] and high-grade [n = 28] MALT lymphoma).



RESULTS: On upper gastrointestinal radiography, ulceration (39%) was the most common finding in low-grade lymphoma, whereas polypoid appearance (38%) was the most common in high-grade lymphoma. In the 29 patients (33 lesions) with low-grade MALT lymphoma, upper gastrointestinal radiography revealed 13 ulcerative lesions (39%), 10 nodular lesions (30%), four infiltrative lesions (12%), two polypoid lesions (6%), and four combined lesions (12%). In the 28 patients (29 lesions) with high-grade lymphoma, upper gastrointestinal radiography revealed 11 polypoid lesions (38%), nine infiltrative lesions (31%), six ulcerative lesions (20%), one nodular lesion (3%), and two combined lesions (7%). On CT, thickening of the gastric wall in low-grade lymphoma (range, 0.3-2.5 cm; mean, 0.8 cm) was much less than that in high-grade lymphoma (range, 0.7-8.0 cm; mean, 2.5 cm). Abdominal lymphadenopathy was less frequent in low-grade lymphoma (14%) than in high-grade lymphoma (75%).



CONCLUSION: Most low-grade lymphomas show superficial spreading lesions, such as mucosal nodularity, shallow ulcer, and minimal fold thickening, on upper gastrointestinal radiography, whereas most high-grade lymphomas show mass-forming lesions or severe fold thickening.
MeSH terms
AdultAgedAnalysis of VarianceContrast MediaFemaleHelicobacter Infections/complications/drug therapyHelicobacter pyloriHumansLymphoma, B-Cell/complications/pathology/*radiographyLymphoma, B-Cell, Marginal Zone/complications/pathology/*radiographyLymphoma, Non-Hodgkin/complications/pathology/*radiographyMaleMiddle AgedRetrospective StudiesStomach Neoplasms/complications/pathology/*radiography*Tomography, X-Ray Computed
DOI
10.2214/ajr.179.5.1791297
PMID
12388517
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
AJOU Authors
김, 재근
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