Gastric lymphoma accounts for less than 15% of all stomach tumors. They arise from the lymphatic system, the cell waste removal system of the body.
They can be divided in to B and T-cell malignancies and are rare, accounting for less than 15% of all stomach cancers.
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When a cell dispatches its waste products, it does so in to the lymphatics.
The fluid travels in lymphatic fluid through to lymph nodes which filter the fluid and waste to the spleen where it further filtering occurs.
By doing so, these glands remove bacteria and have lymphocyte cells within to destroy them.
If the lymphocytes start to divide uncontrollably, lymphoma results and it depends on whether they are T-lymphocytes, of thymus origin hence the T, or B-lymphocytes (the B comes from a specific bird organ known as the bursa of Fabricius) as to the cancer type.
These tumors can occur sporadically, without a known cause, or can occur when infected with a bacterium know as helicobacter pylori which resides in the stomach.
This latter cause is associated with a specific tumor known as Maltoma or MALT lymphoma (Mucosal Associated Lymphoid Tissue).
Low immunity conditions including HIV and AID’s and some autoimmune conditions such as rheumatoid arthritis, Hashimoto's Thyroiditis and Sjogrens disease are also risk factors for the condition.
Celiac disease, a condition that is caused by gluten intolerance (gluten is a protein in wheat, barley and rye) is associated with T-cell lymphoma of the small bowel and stomach.
Men are 2 to 3 times more likely to develop them.
The main symptoms of lymphoma include:
This form of tumor is normally diagnosed at endoscopy.
Further investigations including:
may be used to stage the disease.
A bone marrow biopsy and trephine is usually done to look for marrow involvement.
MALT lymphoma can be treated with helicobacter pylori eradication therapy and can cause tumor regression in up to 70% of cases.
Eradication therapy is normally with a combination of antibiotics and acid suppressants such as proton pump inhibitors (Omeprazole and Lanzoprazole being the most common).
Surgery is rarely undertaken unless complications such as gastric outlet obstruction or uncontrolled gastrointestinal bleeding occur.
Survival rates for these tumors range from 91% 5 year survival if the histology is low grade, 73% if it is secondary high grade and 56% for the primary, high grade type.
Better prognosis is associated with low grade disease, if you are under 65 years of age and when there is a good response to initial treatment.
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