GIST and Lymphoma

GIST (Gastrointestinal stromal tumor)

GIST most commonly affects the stomach. Other sites include the esophagus, small intestine, and rectum.

Clinical presentation

• Asymptomatic lesions are usually detected by CT scan or endoscopy

• GI bleeding presents as black colored stools and hematemesis

• Abdominal pain

• Obstructive features include dysphagia, abdominal distension, severe pain abdomen, and recurrent vomiting

Diagnosis

Diagnostic tests include:

• CECT abdomen

• Endoscopy and endoscopic ultrasound

• PET scan to assess distant metastasis

Treatment

• Small GIST requires follow-up

• Large tumor in absence of metastasis requires surgery

• Chemotherapy with imatinib and sunitinib is indicated for unresectable tumors, and when the surgical approach is not feasible.

Gastric Lymphoma

Gastric lymphoma represents 3-5 % of all gastric tumors. The most common extranodal site of lymphoma is the stomach.

Marginal zone B cell lymphoma is called as MALT lymphoma. It is the most common lymphoma of the stomach.

The main causative factor for this lymphoma is chronic H pylori infection that causes chronic gastritis.

Clinical features

• Dyspepsia

• Epigastric pain

• Nausea and vomiting

• Early satiety

• GI bleeding

• Fever

• Weight loss

Diagnosis

Endoscopy identifies the lesions, and endoscopic findings are

• Erythema

• Erosions

• Ulcers

• Growth

A biopsy is taken from suspicious areas

CT and EUS indicated to determine the extent of diseases and metastasis

Treatment

• The initial stage of the disease can be managed by H Pylori eradication.

• Patients with advanced disease should undergo chemotherapy treatment

Diffuse large B cell lymphoma

H pylori is associated in the pathogenesis of the lymphoma, however the relationship is still unclear.

Clinical symptoms

• Epigastric pain

• Dyspepsia

• A large tumor that causes obstruction

• An ulcerated mass that may bleed

Diagnosis

• Upper GI endoscopy and biopsy are important for diagnosing the disease.

• Endoscopic findings reveal ulceration and a large tumor

• The common sites include body and antrum

• CT/PET and EUS are useful for tumor staging

Treatment

• The main treatment modality is chemotherapy with or without radiotherapy

Need Expert Medical Guidance for GIST and Lymphoma?

Consult University Gold Medalist Dr. Ankita Gupta at Gastro Liver Endoscopy Centre, Greater Kailash-I, New Delhi for customized diagnostic evaluations.