GIST and Lymphoma

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


Diagnostic tests include:

  • CECT abdomen
  • Endoscopy and endoscopic ultrasound
  • PET scan to assess distant metastasis


  • 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


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


  • 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


  • 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


  • The main treatment modality is chemotherapy with or without radiotherapy
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