Definition and Epidemiological Data

Primary gastric lymphoma (PGL) belongs to the group of non-Hodgkin's lymphomas that are malignant clonal diseases of the lymphatic system. Gastric lymphomas are considered primary when the stomach is predominantly involved and the intra-abdominal lymphadenopathy, if present, corresponds to the expected lymphatic drainage of the stomach. Patients with palpable subcutaneous nodes, mediastinal lymphadenopathy, or abnormal leukocytes on peripheral blood smear or bone marrow aspirates are not categorized as having PGL. The criteria also exclude those with splenic or liver involvement. These strict criteria exclude many advanced cases, which can result in an underestimate of the frequency of the disease. Most PGL are B-cell in origin, although occasional cases of T-cell and Hodgkin's lymphoma are seen. Although there are several clinico-pathological entities of PGL (eg, mantle cell lymphoma, lymphocytic lymphoma [chronic lymphocytic leukemia], and follicular lymphoma), a significant proportion of PGL is of low grade histology and arises from mucosal-associated lymphoid tissue (MALT). Normal stomachs do not contain this type of organized lymphoid tissue.

PGL is a rare malignancy occurring in only 1 in 30,000 to 1 in 80,000 of the US population per year. This malignancy represents approximately 2 to 7% of primary gastric tumors and 20% of all primary extranodal lymphomas according to the End Results Groups Cancer Registries in the United States (Aisenberg, 1995). Some recent, well-structured, epidemiological studies have found that the incidence of PGL has increased during the last two decades worldwide. An analysis performed in demographically comparable communities of the United Kingdom and Italy revealed a higher incidence of PGL in northeastern Italy than in the corresponding UK communities, suggesting the existence of geographic variations in the incidence of PGL (Doglioni et al, 1992). Gastric lymphomas occur predominantly in individuals over 50 years of age, with a peak in the seventh decade, but the disease can occur at any age. The male to female ratio is approximately 1.7:1. Because MALT lymphomas are by large the most common pathological entity among all PGLs, this chapter will focus on them.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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