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Pathological disorders of the gastric mucosa surrounding carcinomas and primary lymphomas.
Am J Gastroenterol. 2001 Jun; 96(6):1746-50.AJ

Abstract

OBJECTIVE

Gastritis, intestinal metaplasia, atrophy, and dysplasia are disorders that frequently precede the full development of gastric adenocarcinoma. On the other hand, primary gastric lymphomas seem to arise from mucosa-associated lymphoid tissue. It is well accepted that these histological changes are caused by Helicobacter pylori infection. The objective of this study is to determine the frequency and characteristics of epithelial and lymphoid tissue disorders of the gastric mucosa surrounding primary carcinomas and lymphomas.

METHODS

We studied 111 gastrectomies from patients harboring primary adenocarcinomas (30 intestinal and 30 diffuse type) and 51 gastric lymphomas. For comparative purposes, we analized 86 stomachs from patients who died of diseases other than gastric malignancies. Histopathological disorders of the gastric mucosa adjacent to primary neoplasms such as atrophy, intestinal metaplasia, and dysplasia were recorded. Lymphoid follicles were classified in two groups, with or without expansion. Expansion was characterized by increased size, irregular borders, enlarged marginal zone, and expanded germinal centers. Differences were statistically evaluated with chi2 and Fisher exact tests, odds ratio, and relative risk, with 95% CI. p values <0.05 were considered statistically significant.

RESULTS

Most intestinal-type adenocarcinomas showed atrophy (76.6%) and intestinal metaplasia (86.6%) and less frequently, dysplasia (23.3%), in the surrounding gastric mucosa. Expansive lymphoid follicles were more frequent among lymphomas than in adenocarcinomas (56.8% vs 25%); however, a high percentage of lymphomas were also associated with atrophy (50.9%), intestinal metaplasia (62.7%), and rarely dysplasia (11.8%). On the contrary, diffuse-type adenocarcinoma displayed less frequently atrophy (33%), intestinal metaplasia (50%), and dysplasia (3%). Gastric mucosa from patients without any gastric neoplasia was almost normal (84%), whereas the remaining 16% showed, both or alone, atrophy and intestinal metaplasia.

CONCLUSION

Histopathological disorders of the gastric mucosa are not specific for any neoplasm, but intestinal-type adenocarcinomas frequently showed atrophy, intestinal metaplasia, and not uncommonly, dysplasia of the surrounding non-neoplastic gastric mucosa. Diffuse-type adenocarcinomas did not frequently show such lesions. Primary lymphomas displayed expansive lymphoid follicles and also a high percentage of atrophy and intestinal metaplasia of the surrounding gastric mucosa. The presence of intestinal metaplasia, atrophy, and lymphoid follicles with expansion in endoscopic biopsies could suggest a higher suceptibility for the development of gastric intestinal-type adenocarcinoma or gastric lymphoma. Patients harboring such histopathological changes must receive eradication therapy against H. pylori and probably closer follow-up.

Authors+Show Affiliations

Department of Pathology, Instituto Nacional de la Nutrición Salvador Zubirán, México DF, Mexico.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

11419824

Citation

Arista-Nasr, J, et al. "Pathological Disorders of the Gastric Mucosa Surrounding Carcinomas and Primary Lymphomas." The American Journal of Gastroenterology, vol. 96, no. 6, 2001, pp. 1746-50.
Arista-Nasr J, Jiménez-Rosas F, Uribe-Uribe N, et al. Pathological disorders of the gastric mucosa surrounding carcinomas and primary lymphomas. Am J Gastroenterol. 2001;96(6):1746-50.
Arista-Nasr, J., Jiménez-Rosas, F., Uribe-Uribe, N., Herrera-Goepfert, R., & Lazos-Ochoa, M. (2001). Pathological disorders of the gastric mucosa surrounding carcinomas and primary lymphomas. The American Journal of Gastroenterology, 96(6), 1746-50.
Arista-Nasr J, et al. Pathological Disorders of the Gastric Mucosa Surrounding Carcinomas and Primary Lymphomas. Am J Gastroenterol. 2001;96(6):1746-50. PubMed PMID: 11419824.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pathological disorders of the gastric mucosa surrounding carcinomas and primary lymphomas. AU - Arista-Nasr,J, AU - Jiménez-Rosas,F, AU - Uribe-Uribe,N, AU - Herrera-Goepfert,R, AU - Lazos-Ochoa,M, PY - 2001/6/23/pubmed PY - 2001/8/31/medline PY - 2001/6/23/entrez SP - 1746 EP - 50 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 96 IS - 6 N2 - OBJECTIVE: Gastritis, intestinal metaplasia, atrophy, and dysplasia are disorders that frequently precede the full development of gastric adenocarcinoma. On the other hand, primary gastric lymphomas seem to arise from mucosa-associated lymphoid tissue. It is well accepted that these histological changes are caused by Helicobacter pylori infection. The objective of this study is to determine the frequency and characteristics of epithelial and lymphoid tissue disorders of the gastric mucosa surrounding primary carcinomas and lymphomas. METHODS: We studied 111 gastrectomies from patients harboring primary adenocarcinomas (30 intestinal and 30 diffuse type) and 51 gastric lymphomas. For comparative purposes, we analized 86 stomachs from patients who died of diseases other than gastric malignancies. Histopathological disorders of the gastric mucosa adjacent to primary neoplasms such as atrophy, intestinal metaplasia, and dysplasia were recorded. Lymphoid follicles were classified in two groups, with or without expansion. Expansion was characterized by increased size, irregular borders, enlarged marginal zone, and expanded germinal centers. Differences were statistically evaluated with chi2 and Fisher exact tests, odds ratio, and relative risk, with 95% CI. p values <0.05 were considered statistically significant. RESULTS: Most intestinal-type adenocarcinomas showed atrophy (76.6%) and intestinal metaplasia (86.6%) and less frequently, dysplasia (23.3%), in the surrounding gastric mucosa. Expansive lymphoid follicles were more frequent among lymphomas than in adenocarcinomas (56.8% vs 25%); however, a high percentage of lymphomas were also associated with atrophy (50.9%), intestinal metaplasia (62.7%), and rarely dysplasia (11.8%). On the contrary, diffuse-type adenocarcinoma displayed less frequently atrophy (33%), intestinal metaplasia (50%), and dysplasia (3%). Gastric mucosa from patients without any gastric neoplasia was almost normal (84%), whereas the remaining 16% showed, both or alone, atrophy and intestinal metaplasia. CONCLUSION: Histopathological disorders of the gastric mucosa are not specific for any neoplasm, but intestinal-type adenocarcinomas frequently showed atrophy, intestinal metaplasia, and not uncommonly, dysplasia of the surrounding non-neoplastic gastric mucosa. Diffuse-type adenocarcinomas did not frequently show such lesions. Primary lymphomas displayed expansive lymphoid follicles and also a high percentage of atrophy and intestinal metaplasia of the surrounding gastric mucosa. The presence of intestinal metaplasia, atrophy, and lymphoid follicles with expansion in endoscopic biopsies could suggest a higher suceptibility for the development of gastric intestinal-type adenocarcinoma or gastric lymphoma. Patients harboring such histopathological changes must receive eradication therapy against H. pylori and probably closer follow-up. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/11419824/Pathological_disorders_of_the_gastric_mucosa_surrounding_carcinomas_and_primary_lymphomas_ L2 - https://doi.org/10.1111/j.1572-0241.2001.03868.x DB - PRIME DP - Unbound Medicine ER -