GIST and Lymphoma

GIST (Gastrointestinal stromal tumor)

Stomach is the most common site for the GIST, other sites include small intestine, rectum, and esophagus
Clinical presentation

  • Asymptomatic lesion detected during endoscopy or CT scan
  • GI bleed in the from of hemetemesis and black colored stools
  • Abdominal pain
  • Obstructive features such as dysphagia, recurrent vomiting, abdominal distension, and severe pain abdomen

Following test are required for diagnosis and management  

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


  • Small GIST can be followed up
  • Large tumor without metastasis should be operated
  • Unresectable tumors, and in patients where surgery is not feasible, are best treated by chemotherapy with imatinib and sunitinib

Gastric Lymphoma
Gastric lymphoma constitute 3-5 % of all gastric tumors. Stomach is the most common extranodal site of lymphoma.

Marginal zone B cell lymphoma of stomach
Marginal zone B cell lymphoma, also known as MALT lymphoma is the most common lymphoma of stomach, chronic H pylori infection leading to chronic gastritis is the underlying cause.

Clinical features

  • Dyspepsia
  • Epigastric pain
  • Nausea, vomiting and early satiety
  • GI bleeding
  • Fever, vomiting and weight loss

Lesions are usually diagnosed by endoscopy, endoscopic findings are

  • Erythema
  • Erosions
  • Ulcers
  • Growth.
  • Biopsy is taken from the suspicious areas
  • CT and EUS are the investigations required for evaluation of extent of diseases and  metastasis


  • Early state disease can be treated by eradication of H Pylori
  • Advanced disease is treated by chemotherapy

Diffuse large B cell lymphoma
The role of H pylori in the pathogenesis is not very clear
Clinical symptoms

  • Epigastric pain and dyspepsia
  • Large tumor may cause obstruction
  • Ulcerated lesion may bleed


  • Upper GI endoscopy and biopsy are required for the diagnosis
  • Endoscopic findings are large tumor and ulcer
  • Body and antrum are common sites
  • CT/PET and EUS are done for staging


  • Chemotherapy with or without radiotherapy is mainstay of treatment


Aman Gupta

Wonderful experience. One extremely good thing about Dr Ankita is that she is very polite and patient. She hears his patients completely and with my personal experience I feel she never gives unnecessary medicine. She is very experienced *** ******** in his profession. I appreciate her and will always recommend my family and friends to visit her.