Long‐term follow up of gastric low‐grade mucosa‐associated lymphoid tissue lymphoma by endosonography emphasizing the application of a miniature ultrasound probe

Abstract

Endoscopic ultrasonography plays a valuable role in the initial staging and long-term follow up of gastric low-grade MALT lymphoma. The application of a miniature ultrasound probe enables adequate evaluation in the majority of these patients, with additional benefits.

Role of the Endoscopic Ultrasonography in the Management of Gastric Lymphomas: Our Experience and Review of Literature

“…On the contrary, another study confirmed that EUS is reliable in determining tumor regression or relapse with a concordance between EUS and endoscopic biopsies of about 80% (Lügering et al, 2001). During 2003, two other reports stated that EUS is a reliable tool in determining the response evaluation and the early detection of disease reappearance, thus avoiding the performance of invasive procedures (Hoepffner et al, 2003;Yeh et al, 2003). In addition, the Serbian group found a stringent correlation between EUS and histology in patients treated both with HP-eradicating therapy and/or chemotherapy ± radiotherapy (Pavlović et al 2005).…”

“…However, the importance of EUS in assessing the response to treatment and the follow-up is controversial. During the last decade, some reports indicated the importance of EUS in evaluating the response to treatment and also in long-term follow-up of gastric lymphomas with limited disease (Yeh et al, 2003), whereas other recent reports indicated the importance of EUS also in the follow-up of local-advanced MALT lymphoma (Pavlović et al, 2005). That notwithstanding, the latest ESMO clinical guidelines for diagnosis, treatment and follow-up…”

EUS in the Evaluation of Gastric Tumors

“…Yeh et al, 83 however, concluded differently in another trial evaluating the role of EUS in 20 patients with low-grade gastric MALT lymphoma before and after H. pylori eradication therapy. Of 17 patients who were H. pylori positive, 14 (82%) obtained histologic remission.…”

“…• Post-treatment follow-up: EUS may reveal restoration of normal gastric wall layers or significant reduction in thickness of the wall layers following successful treatment. 83 Patients with persistently thick gastric wall layers on follow-up EUS examinations are more likely to have residual disease, even when results of endoscopic biopsy are negative. These patients most likely have persistent lymphoma that may warrant additional therapy.…”

Staging role of EUS

“…Miniprobes with higher ultrasound frequencies may provide results superior to those obtained by conventional EUS [16,17]. EUS elastography may give additional information on the dignity of lymph nodes as it has been shown for metastatic carcinoma [18,19].…”