Endoscopic Ultrasonography in the Local Staging of Primary Gastric Lymphoma

L. Palazzo; G. Roseau; A. Ruskone-Fourmestraux; Ph. Rougier; S. Chaussade; J.-C. Rambaud; D. Couturier; J.-A. Paolaggi

doi:10.1055/s-2007-1010385

Endoscopy 1993; 25(8): 502-508
DOI: 10.1055/s-2007-1010385

Endoscopic Ultrasonography in the Local Staging of Primary Gastric Lymphoma

L. Palazzo¹ , G. Roseau¹ , A. Ruskone-Fourmestraux² , Ph. Rougier³ , S. Chaussade¹ , J.-C. Rambaud⁴ , D. Couturier¹ , J.-A. Paolaggi¹

¹Dept. of Gastroenterology, Cochin Hospital, University Paris V
²Dept. of Gastroenterology, Hotel Dieu de Paris, University Paris VI
³Dept. of Gastroenterology, Institut Gustave Roussy, Villejuif (94)
⁴Dept. of Gastroenterology, St-Lazare Hospital, University Paris VII

Abstract

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Abstract

Endoscopic ultrasonography (EUS) and endoscopy were prospectively performed and compared to the histopathologic findings of the resection specimens in 24 patients with primary gastric lymphoma (PGL). On EUS, three types of PGL could be differentiated, a superficial type (n = 10), an infiltrating type (n = 12) and a tumorous type (n = 2). In the correct assessment of surface extension of the tumors, endoscopy and EUS agreed in 37,5 % of cases and EUS showed more extensive disease than endoscopy in 58 % of cases. However, in comparison to the resection specimens, EUS still underestimated the tumor surface extension in 37.5 % of cases; this was mainly in low grade malignant PGL. The depth of tumor infiltration was correctly determined on EUS compared to the resection specimens in 91.5 % of cases. Sensitivity, specificity and accuracy of diagnosing lymph node metastases were 100 %, 80 % and 83 %, respectively. We conclude that EUS is a useful pre-therapeutic staging tool for primary gastric lymphoma but there remain some problems in determining the longitudinal and circular tumor spread in order to accurately guide the extent of gastric resection.

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