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.
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.
Authors: H Isomoto; S Shikuwa; N Yamaguchi; K Miyazato; K Ohnita; T Hayashi; Y Mizuta; M Ito; S Kohno Journal: Endoscopy Date: 2008-02-11 Impact factor: 10.093
Authors: Thomas Wündisch; Christian Thiede; Andrea Morgner; Astrid Dempfle; Annette Günther; Hongxiang Liu; Hongtao Ye; Ming-Qing Du; Theo D Kim; Ekkehard Bayerdörffer; Manfred Stolte; Andreas Neubauer Journal: J Clin Oncol Date: 2005-10-03 Impact factor: 44.544
Authors: W Fischbach; B Dragosics; M E Kolve-Goebeler; C Ohmann; A Greiner; Q Yang; S Böhm; P Verreet; O Horstmann; M Busch; E Dühmke; H K Müller-Hermelink; K Wilms; S Allinger; P Bauer; S Bauer; A Bender; G Brandstätter; A Chott; C Dittrich; K Erhart; D Eysselt; H Ellersdorfer; A Ferlitsch; M A Fridrik; A Gartner; M Hausmaninger; W Hinterberger; K Hügel; P Ilsinger; K Jonaus; G Judmaier; J Karner; E Kerstan; P Knoflach; K Lenz; A Kandutsch; M Lobmeyer; H Michlmeier; H Mach; C Marosi; W Ohlinger; H Oprean; H Pointer; J Pont; H Salabon; H J Samec; A Ulsperger; A Wimmer; F Wewalka Journal: Gastroenterology Date: 2000-11 Impact factor: 22.682
Authors: Andrea Morgner; Renate Schmelz; Christian Thiede; Manfred Stolte; Stephan Miehlke Journal: World J Gastroenterol Date: 2007-07-14 Impact factor: 5.742
Authors: W Fischbach; M E Goebeler; A Ruskone-Fourmestraux; T Wündisch; A Neubauer; M Raderer; A Savio Journal: Gut Date: 2007-07-16 Impact factor: 23.059