“…The role of surgery in the treatment of gastrointestinal lymphoma has been a matter of debate. [13][14][15][16][17][18]30,31,45,46 Although past studies showed that surgical resectability was of significance, recent studies have demonstrated that nonsurgical strategies and surgery-based modalities had an equivalent efficacy. 30,31,45 Based on all these observations, and taking patients' quality of life into consideration, nonsurgical treatment is an alternative and optimal therapeutic modality for gastrointestinal lymphoma.…”
“…The role of surgery in the treatment of gastrointestinal lymphoma has been a matter of debate. [13][14][15][16][17][18]30,31,45,46 Although past studies showed that surgical resectability was of significance, recent studies have demonstrated that nonsurgical strategies and surgery-based modalities had an equivalent efficacy. 30,31,45 Based on all these observations, and taking patients' quality of life into consideration, nonsurgical treatment is an alternative and optimal therapeutic modality for gastrointestinal lymphoma.…”
“…The authors claim that, except for H. pylori -positive indolent lymphoma stage I E and locally advanced high-grade lymphomas, resection remains the therapy of choice. However, they also propose a randomized trial comparing surgery with conservative treatment (67).…”
“…In a series of 266 patients with gastric B cell lymphoma, Fischbach et al showed that biopsy could only achieve a correct type and grading in 73% of them comparing to surgically resected specimens. 5 The discrepancy was attributed to missing of malignant foci upon endoscopy in 13% of these biopsies, as previously no report described the endoscopic appearance of gastric MALToma. In this report, we evaluated the microstructural and microvascular patterns observed upon magnifying endoscopy with a view to improving the diagnostic accuracy during endoscopy for gastric MALToma.…”
Background and objectives:Gastric MaLToma is difficult to recognize upon endoscopy. The aim of this study is to evaluate the application of microstructural and microvascular patterns in recognizing gastric MaLToma on magnifying endoscopy. Method: all patients with diagnosis of gastric MaLToma upon histology were recruited. They received magnifying endoscopy to observe for changes in microstructural and microvascular patterns. For patients with h pylori, eradication therapy would be given. For those without, appropriate treatments including gastrectomy or chemotherapy were commenced accordingly. patients treated with h pylori eradication and non-operative treatments received follow-up magnifying endoscopy, and the same features were observed to predict the response to these treatments. Results: From 2004 to 2007, nine patients presented to with epigastric pain, dyspepsia and belching. all patients were confirmed to have MaLToma upon initial biopsy. Five patients had h pylori infection and received eradication. Two patients without h pylori were treated with Laparoscopic total gastrectomy. Two patients had pulmonary metastasis and treated with chemotherapy. Under magnifying endoscopy, all the lesions demonstrated either absence or irregular gastric pits. Moreover, there was consistently appearance of spider-shaped vascular pattern. Five patients with h pylori eradication had follow-up magnifying endoscopy, four of them showed resolution of abnormal vascular pattern and recovery of gastric pits. Conclusion: abnormal spider like vasculature and disappearance of gastric pits are diagnostic features upon magnifying endoscopy for gastric MaLToma. These features enhanced the diagnosis and assessment of extent of involvement during primary endoscopy, as well as follow-up surveillance for response to non-operative treatments.
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