Membrillo-Romero A, Escandón-Espinoza YM

Language: Spanish
References: 14
Page: 202-207
PDF size: 316.67 Kb.

ABSTRACT

Introduction: The prevalence of gastric cancer in Mexico has increased in recent years, with a predominance in men. Risk factors are alcohol, tobacco, and Helicobacter pylori infection, considered in our population as of a moderate risk. Although adenocarcinoma continues to predominate as the most frequent gastric malignancy, according to the WHO, a non-negligible percentage (7-8%) is occupied by extra-nodal non-Hodgkin's lymphoma and leiomyosarcomas. Appropriate diagnostic approach and differentiation between adenocarcinoma and lymphoma are crucial since prognosis and treatment depend on it. Case report: A 79-year-old man with asthenia, malignant hypercalcemia and an incidental gastric thickening found by tomography. Endoscopic ultrasound was performed and the diagnosis of gastric lymphoma of a diffuse variety (Ann Arbor modified II2) was established. Literature review: Endoscopic ultrasound is considered a tool for the diagnosis of gastric carcinoma in all variants, mainly where the disease is in deep layers. Conclusion: Endoscopic ultrasound is a method that leads to high diagnostic accuracy in gastric lymphoma allowing biopsies of total wall thickness for immunohistochemistry.

REFERENCES

1. Perfil epidemiológico de los tumores malignos en México. Compendio morbilidad/mortalidad. México: Secretaría de Salud; 2011.

2. Galindo F, Castro RM. Linfoma gástrico. Cirugía digestiva. www.sacd.org.ar, 2009; II-227, 1-11.

3. Ginès A, Pellise M, Fernández-Esparrach G, Soria MT, Mata A, Membrillo A, et al. Endoscopic ultrasonography in patients with large gastric folds at endoscopy and biopsies negative for malignancy: predictors of malignant disease and clinical impact. Am J Gastroenterol. 2006; 101: 64-69.

4. Siewert JR, Fink U, Sendler A, Becker K, de Bottcher K, Feldmann HJ, et al. Gastric cancer. Curr Probl Surg. 1997; 34: 835-939.

5. Botet JF, Lightdale CJ, Zauber AG, Gerdes H, Winaver SJ, Urmacher C, et al. Preoperative staging of gastric cancer: comparison of endoscopic US and dynamic CT. Radiology. 1991; 181: 426-432.

6. Akahoshi K, Misawa T, Fujishima H, Chijiiwa Y, Maruoka A, Ohkubo A, et al. Preoperative evaluation of gastric cancer by endoscopic ultrasound. Gut. 1991; 32: 479-482.

7. Chiu B, Weisenburger D. An update of the epidemiology of non-Hodgkin's lymphoma. 2014; 12: 1282-1303.

8. Dicken BJ, Bigam DL, Cass C, Mackey JR, Joy AA, Hamilton SM. Gastric adenocarcinoma: review and considerations for future directions. Ann Surg. 2005; 241: 27-39.

9. Lee DH, Ko YT. Advanced gastric carcinoma: the role of three- dimensional and axial imaging by spiral CT. Abdom Imaging. 1999; 24: 111-116.

10. Nickl NJ, Cotton PB. Clinical application of endoscopic 
ultrasonography. Am J Gastroenterol. 1990; 85: 675-682.

11. Cavanna L, Pagani R, Pietro S, Zangrandi A, Paties C. High grade B-cell gastric lymphoma with complete pathologic remission after eradication of Helicobacter pylori infection: report of a case and review of literature. World J Surg Oncol. 2008; 6: 35.

12. Suekane H, Iida M, Yao T, Matsumoto T, Masuda Y, Fujishima M. Endoscopic ultrasonography in primary gastric lymphoma: correlation with endoscopic and histologic findings. Gastrointest Endosc. 1993; 39: 139-145.

13. Caletti G, Fusaroli P, Togliani T, Bocus P, Roda E. Endosonography in gastric lymphoma and large gastric folds. Eur J Ultrasound. 2000; 11: 31-40.

14. Ponce GJ, Castells GA, Gomollón GF, Esteve CM, de Argila C, Molero RX, et al. Tratamiento de las enfermedades gastroenterológicas. Asociación Española de Gastroenterología. 2011; 12: 1-551.