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Korean J Helicobacter  Up Gastrointest Res > Volume 15(2); 2015 > Article
The Korean Journal of Helicobacter  and Upper Gastrointestinal Research 2015;15(2):117-123.
DOI: https://doi.org/10.7704/kjhugr.2015.15.2.117    Published online June 10, 2015.
Endoscopic Appearances with a High Probability of Positive Biopsy in Follow-up Endoscopy of Gastric Mucosa-associated Lymphoid Tissue Lymphoma
Han Hee Lee, In Seok Lee, Chul Hyun Lim, Jin Su Kim, Yu Kyung Cho, Jae Myung Park, Sang Woo Kim, Seung Eun Jung, Byung Ock Choi, Seok Goo Cho, Myung Gyu Choi
1Department of Gastroenterology, College of Medicine, The Catholic University of Korea, Seoul, Korea. isle@catholic.ac.kr
2Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
3Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
4Department of Hematology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Remission of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is difficult due to pleomorphic and multifocal endoscopic findings. We investigated the relationship between endoscopic appearances and histological findings of patients followed up after curative treatment for the tumor. MATERIALS AND METHODS: This retrospective study included 25 consecutive patients diagnosed with gastric MALT lymphoma, who were treated and underwent serial follow-up endoscopies with biopsies from June 2009 to March 2014 in Seoul St. Mary's Hospital. We reviewed the follow-up endoscopic findings at least 2 months after Helicobacter pylori eradication or chemoradiotherapy. Target biopsy sites were categorized according to their endoscopic appearance. RESULTS: The mean follow-up period was 17.6 months; 76 endoscopies and 238 biopsies were performed. Positive biopsies were observed in 50 cases (21.0%). Tumor positivity was high in ulcerated lesions (2/3, 66.7%), erosion (1/5, 20.0%), discoloration (32/89, 36.0%), mucosal thickening (10/41, 24.4%) and ulcer scars (3/21, 14.3%). Conversely, lesions appearing normal showed low positivity (1/68, 1.5%) and was significantly lower compared with the aforementioned lesions (P<0.001). CONCLUSIONS: Endoscopic appearances of depression, discoloration, mucosal thickening and ulcer scars were more likely to have tumor cells and should be targeted during follow up for gastric MALT lymphoma.
Key Words: Lymphoma, B-Cell, marginal zone; Lymphoma, non-Hodgkin; Follow-up studies; Endoscopy, gastrointestinal

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