[Endoscopic-histopathological correlation in gastric lymphoma diagnosis: the experience of an oncologic institute].

Abstract

Among the Gastric Lymphoma' chief features are the varied endoscopic appearances and the difficulty for its conventional bioptic diagnosis. In order to focusing on this problem we analyzed 15 years of experience on this matter at the "Luis Razetti" Oncological Institute. 10 cases were morphologicaly classified as follow: a) Exophytic type 5/50%. The most difficult morphology for its endoscopic diagnosis was the infiltrative type, in its large gastric folds category 2/20%, yielding a 33% of bening diagnosis. Histopathologicaly a 66% of bening diagnosis was obtained and a 33% of uncertain diagnosis. The exophytic type in its erosive protruding mass category was the second most difficult morphology fot both endoscopic and histopathologic diagnosis. When the last two categories were associated with ulceration, the malignant diagnosis increased. 40 of the cases were operated on without preoperative histological diagnosis. All the cases were operated on without preoperative histological diagnosis. All the cases corresponded with Large cells diffuse type of Non Hodgkin's Lymphoma, a diagnosis reached in only one opportunity by endoscopic biopsy. No correlation between tumoral morphology and intraparietal growth was found. 3 patients survived for more than 1 years. It can be concluded that video endoscopic methods could help to improve the endoscopic knowledge in gastric lymphoma diagnosis, while polipectomy snare biopsy, dye methods like Indigo Carmin and special techniques like mucosectomy could help to improve the histologic diagnosis, because conventional biopsy provides small and superficial samples.