These tumors, which may imitate primary adenocarcinomas of the stomach, are uncommon, making up only about 5 percent of gastric malignancies. These tumors are becoming more common, however.
A recent association has been shown between gastric lymphomas and ulcers and an infection with Helicobacter pylori. Eradication of the infection with antibiotics may lead to a regression of the lymphoma in some cases.
Patients with gastric lymphoma should have a general lymphoma evaluation including a chest x-ray, chest, pelvic, and abdominal CT scans, bone marrow biopsies.
Standard Treatment Removing part of the stomach, if possible, may be the ideal treatment. In one series of 50 consecutive cases, a survival of 90 percent was obtained when the tumor involved only the mucosa, 80 percent when it involved the submucosa. A study for Stages IE and IIE (local tumor extension) lymphoma showed that patients who had four courses of CHOP (Cytoxan + Adriamycin + Oncovin + prednisone) followed by radiation therapy and then additional chemotherapy did as well as patients who had surgery.
When the lymphoma fully penetrates the gastric wall and the lymph nodes in the region become involved, the survival is decreased to about 25 percent.
Radiation after surgery helps reduce the chance for local recurrences and is appropriate adjuvant therapy, especially for IE and IIE tumors. The radiation therapy port usually covers the upper abdomen as well as the
