Endoscopic Retrospective Study on Gastric Malignant Lymphoma—with Special Reference to the Appearance of the Initial Lesion—

Abstract

An endoscopic retrospective study was performed on five lesions in four patients with gastric malignant lymphoma, in order to elucidate the characteristics of the initial lesion and the growth process of these lymphomas.In case 1 (protruding type of malignant lymphoma), an area of small macular redness and a shallow ulcer, which had neither a surrounding elevation due to edema nor the circumscribed redness caused by regenerative epithelium, were observed 23 and 11 months before, respectively, when a cobblestone appearance, indicative of early lymphoma of the stomach, was found. A shallow ulcer was also recognized in the initial stage of the disease in case 2 (giant rugal type). Discolored and lustrous granules were obserued as a first endoscopic finding in cases 3 and 4 (ulcerative type). These endoscopic findings were thought to be key findings indicative of gastric malignant lymphoma in the initial stagg. For the early diagnosis of gastric malignant lymphoma, a careful follow-up with a skillfully performed biopsy, i. e. an exactly aimed biopsy using large, sharp-edged forceps, should be carried out if the findings described above are once obserued,