• Epigastric pain and weight loss
• Contrast radiographic or upper GI endoscopic evidence of gastric mass
• Endoscopic biopsy provides diagnosis
• Gastric lymphoma
-Second most common primary cancer of the stomach, representing 2% of the total number
-Most common site of extranodal lymphoma
-Almost all are non-Hodgkin lymphomas, generally classified as B cell mucosa-associated lymphoid tissue (MALT) lymphomas
-Subclassified as low- or high-grade based on nuclear pattern
-20% of patients manifest a second primary cancer in another organ
-Associated with chronic Helicobacter pylori infection
• Gastric pseudolymphoma
• The principal symptoms are epigastric pain and weight loss
• Nausea and vomiting
• Occult GI hemorrhage
• Characteristically, the tumor has attained bulky proportions by the time it is discovered and a palpable epigastric mass is present in 50% of patients
• Pseudolymphoma presents similarly with pain and weight loss
•Barium x-ray studies will demonstrate the lesion
• Gastroscopy with biopsy and brush cytology provides the correct diagnosis preoperatively in about 75% of cases
• CT scan and bone marrow biopsy for preoperative staging
• Epigastric pain and weight loss should prompt upper GI endoscopy, which will reveal the lesion
• Endoscopic biopsy is diagnostic
• 5-year disease-free survival, 50%; correlates with stage, grade, and extent of penetration of the gastric wall
• 60% of recurrences are extra-abdominal
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