Effectiveness of Helicobacter pylori eradication in the treatment of early-stage gastric mucosa-associated lymphoid tissue lymphoma:An up-to-date meta-analysis

BACKGROUND Gastric mucosa-associated lymphoid tissue(MALT)lymphoma(GML)is usually a low-grade B-cell neoplasia strongly associated with Helicobacter pylori(H.pylori)-induced chronic gastritis.Clinical practice guidelines currently recommend H.pylori eradication as the preferred initial treatment for early-stage GML.To determine the practical effect of bacterial eradication as the sole initial therapy for early-stage GML,an updated analysis and review of available evidence is imperative.AIM To perform a meta-analysis to assess the rate of complete remission(CR)of H.pylori-positive early-stage GML following bacterial eradication.METHODS We performed independent,computer-assisted literature searches using the PubMed/MEDLINE,Embase,and Cochrane Central databases through September 2022.Prospective and retrospective observational studies evaluating the CR of early-stage GML following bacterial eradication in H.pylori-positive patients.The risk of bias was assessed using Joanna Briggs Institute(JBI)Critical Appraisal Tools.The pooled estimate of the complete histopathological remission rate and respective confidence intervals(95%CI)were calculated following the random-effects model.Heterogeneity and inconsistency were assessed using Cochran’s Q test and I2 statistic,and heterogeneity was defined as P<0.01 and I²>50%,respectively.Subgroup and meta-regression analyses were conducted to explore potential sources of heterogeneity.RESULTS The titles and abstracts of 1576 studies were screened;96 articles were retrieved and selected for full-text reading.Finally,61 studies were included in the proportional meta-analysis(P-MA).Forty-six were prospective and fifteen were retrospective uncontrolled,single-arm,observational studies.The overall risk of bias was low to moderate in all but a single report,with an average critical appraisal score across all studies of 79.02%.A total of 2936 H.pylori-positive early-stage GML patients,in whom H.pylori was successfully eradicated,were included in the analysis.The pooled CR of H.pylori-positive early-stage GML after bacterial eradication was 75.18%(95%CI:70.45%-79.91%).P-MA indicated the substantial heterogeneity in CR reported across studies(I2=92%;P<0.01).Meta-regression analysis identified statistically significant effect modifiers,including the proportion of patients with t(11;18)(q21;q21)-positive GML and the risk of bias in each study.CONCLUSION Comprehensive synthesis of available evidence suggests that H.pylori eradication is effective as the sole initial therapy for early-stage GML.Although the substantial heterogeneity observed across studies limits the interpretation of the pooled overall CR,the present study is a relevant to informing clinical practice.

Primary lymphoblastic B-cell lymphoma of the stomach:A case report

Primary stomach lymphoblastic B-cell lymphoma (B-LBL) is a rare tumor. We describe a primary stomach B-LBL in a 38 years old female who presented with nonspecific complaints of fatigue and vomiting for 2 mo. Gastrofiberscopy revealed a large gastric ulcer, which was successfully resected. Pathology showed a lymphoblastic cell lymphoma arising from the stomach, and there was no evidence of disease at any extrastomach site. Immunohistochemical staining and gene rearrangement studies supported that the stomach tumor was a clonal B-cell lymphoma. Therefore, the diagnosis of B-LBL was made based on the stomach specimen.

Composite diffuse large B-cell lymphoma and classical Hodgkin's lymphoma of the stomach:Case report and literature review

The combination of classical Hodgkin’s lymphoma(cHL)and non-Hodgkin lymphoma coexisting in the same patient is not common,especially in one extranodal location.Here we present a rare case of composite diffuse large B-cell lymphoma(DLBCL)and cHL occurring simultaneously in the stomach of a 53-year-old female who presented with upper abdominal discomfort and gas pain.Surgery was performed and the disease was diagnosed pathologically as composite lymphoma of DLBCL and cHL using hematoxylin-eosin and immunohistochemical staining.Epstein-Barr virus(EBV)infection was not detected by in situ hybridization for EBV-encoded RNA or immunohistochemistry for EBV latent membrane protein-1.Polymerase chain reaction analysis from the two distinct components of the tumor demonstrated clonal immunoglobulinκlight chain gene rearrangements.The patient died approximately 11 mo after diagnosis in spite of receiving eight courses of the CHOP and two courses of the rituximab-CHOP(RCHOP) chemotherapy regimen.This case report showed that the two distinct components,DLBCL and cHL,appeared to originate from the same clonal progenitor cell,and that EBV infection was not essential for transformation during the course of tumorigenesis.

EBV相关肿瘤和健康人群BALF2基因序列分析

目的探讨BALF2基因的多态性及其分布特征与EB病毒(EBV)相关肿瘤发生发展的关系。方法采用巢式PCR结合DNA测序的方法,对349例EBV阳性标本进行DNA序列分析,利用Lasergene软件将其与EBV标准株B95-8序列进行比对,并生成系统发生树,对基因变异型进行分类。结果根据系统发生树将BALF2分为5个基因型BALF2-A、BALF2-B、BALF2-C、BALF2-D和BALF2-E。其中,BALF2-E在鼻咽癌中的检出率高于健康人群,中国南方鼻咽癌人群BALF2-E的检出率高于北方鼻咽癌人群(χ2=10.26,P<0.01)。结论BALF2基因存在多态性,其变异类型分布与肿瘤类型、地域有关,BALF2-E亚型与鼻咽癌发生相关。

Efficacy of rituximab in gastric diffuse large B cell lymphoma patients

AIM:To evaluate retrospectively the efficacy of rituximab plus chemotherapy in gastric diffuse large B cell lymphoma(DLBCL).METHODS:Sixty patients(median age:58 years)with histologically confirmed gastric DLBCL treated at four Italian institutions between 2000 and 2007,were included in this analysis.Patients were selected by stage (Ⅰ-Ⅳ,Lugano staging system),European Cooperative Oncology Group performance status(0-2)and treatment strategies.Treatment strategies were chemotherapy alone(group A,n=30)[scheduled as cyclophosphamide,doxorubicin,vincristine and prednisone (CHOP)and CHOP-like],and chemotherapy combined with rituximab(group B,n=30).The primary end point of the study was complete response(CR)rate;the secondary end points were disease-free survival (DFS)at 5 years and overall survival(OS).RESULTS:Median follow-up was 62 mo(range:31102 mo).We observed a significant difference between the two groups(A vs B)in terms of CR[76.6%(23/30) vs 100%,P=0.04)and DFS at 5 years[73.3%(22/30) vs 100%,P=0.03).To date,19 group A(63.3%) patients are alive and 11 have died,while all group B patients are alive.No significant differences in toxicity were observed between the two groups.CONCLUSION:Rituximab in combination with chemotherapy improves CR rate,DFS and OS.Further prospective trials are needed to confirm our results.

Development of early gastric cancer 4 and 5 years after complete remission of Helicobacter pyloriassociated gastric low-grade marginal zone B-cell lymphoma of MALT type

AIM: To report 3 of 120 patients on the German MALT lymphoma trial with H. pylori associated gastric MALT lymphoma who developed early gastric cancer 4 and 5 years, after complete lymphoma remission following cure of H. pylori infection. PATIENTS AND RESULTS: Three patients (two men, 74 and 70 years; one women, 77 years) with H. pylori-associated low-grade MALT lymphoma achieved complete lymphoma remission after being cured. Surveillance endoscopies were performed twice a year in accordance to the protocol. Four years after complete lymphoma remission in two patients, and after 5 years in the other, early gastric adenocarcinoma of the mucosa-type, type IIa and type IIc, respectively, was detected, which were completely removed by endoscopic mucosa resection. In one patient, the gastric cancer was diagnosed at the same location as the previous MALT lymphoma, in the other patients it was detected at different sites of the stomach distant from location of the previous MALT lymphoma. The patients were H. pylori negative during the whole follow-up time. CONCLUSION: These findings strengthen the importance of regular Long-term follow-up endoscopies in patients with complete remission of gastric MALT lymphoma after cure of H. pylori infection. Furthermore, gastric adenocarcinoma may develop despite eradication of H. pylori.

Rare gastrointestinal lymphomas: the endoscopic investigation

Gastrointestinal lymphomas represent up to 10%of gastrointestinal malignancies and about one third of nonHodgkin lymphomas.The most prominent histologies are mucosa-associated lymphoid tissue lymphoma and diffuse large B-cell lymphoma.However,the gastrointestinal tract can be the site of rarer lymphoma subtypes as a primary or secondary localization.Due to their rarity and the multifaceted histology,an endoscopic classification has not been validated yet.This review aims to analyze the endoscopic presentation of rare gastrointestinal lymphomas from disease diagnosis to follow-up,according to the involved site and lymphoma subtype.Existing,new and emerging endoscopic technologies have been examined.In particular,we investigated the diagnostic,prognostic and follow-up endoscopic features of T-cell and natural killer lymphomas,lymphomatous polyposis and mantle cell lymphoma,follicular lymphoma,plasma cell related disease,gastrointestinal lymphomas in immunodeficiency and Hodgkin’s lymphoma of the gastrointestinal tract.Contrarily to more frequent gastrointestinal lymphomas,data about rare lymphomas are mostly extracted from case series and case reports.Due to the data paucity,a synergism between gastroenterologists and hematologists is required inorder to better manage the disease.Indeed,clinical and prognostic features are different from nodal and extranodal or the bone marrow(in case of plasma cell disease)counterpart.Therefore,the approach should be based on the knowledge of the peculiar behavior and natural history of disease.

Treatment outcome of localized Helicobacter pylori-negative low-grade gastric MALT lymphoma

AIM: To investigate treatment outcome of Helicobacter pylori (H.pylori )-negative low-grade gastric mucosaassociated lymphoid tissue (MALT) lymphoma.METHODS: In this study,we retrospectively reviewed the clinical outcome and clinicopathologic factors of stage Ⅰ E H.pylori -negative low-grade gastric MALT lymphoma cases from August 1998 to June 2009.RESULTS: A total of eleven patients with H.pylori -negative low-grade gastric MALT lymphoma were enrolled in the study and received anti-H.pylori eradication treatment and/or radiotherapy or excisional therapy.Complete remission (CR) of gastric MALT lymphoma was achieved in all patients.The time to CR was 1-66 mo (median,1 mo).CONCLUSION: Eradication therapy may be offered as an initial treatment option even in cases of localized H.pylori -negative gastric MALT lymphoma.

Gastric amyloidoma in patient after remission of Non-Hodgkin's Lymphoma

Amyloidosis is commonly systemic,occasionally organlimited,and rarely a solitary localized mass.The latter,commonly referred to as tumoral amyloidosis,is described as occurring in nearly every organ/tissue.Only a few reports of gastric amyloidosis exist today.We describe a 72 year-old black male from Barbados presenting with 3 d of diffuse abdominal pain.His medical history included Non-Hodgkin's Lymphoma diagnosed five years ago,status-post six rounds of cyclophosphamide,adriamycin,vincristine,prednisone chemotherapy,and currently was in remission.On computed tomography scan of the abdomen,thickening and calcification of the gastric wall was noted along with pneumatosis.On esophagogastroduodenoscopy,a large circumferential friable mass was seen from the gastroesophageal junction to the body.A large nonbleeding 3 cm polyp was also seen in post bulbar area of duodenum.Biopsies were stained with Congo red and gave green birefringence under polarized light,consistent with tumoral amyloidosis.Positron emission tomography scan revealed diffuse gastric mucosa uptake compatible with gastric malignancy without metastatic foci.Treatment for gastric amyloidomas has presently been one of observation or,at most,resection of the amyloid mass.It is not known if our patient required the same approach or if this warranted the re-institutionof chemotherapy for Non-Hodgkin's Lymphoma.Until more reports of tumoral amyloidosis are made known,treatment as well as prognosis remain uncertain.

幽门螺旋杆菌感染与MALT1基因易位对胃MALT淋巴瘤免疫微环境的影响及意义

目的探究幽门螺旋杆菌(helicobacter pylori,HP)感染和黏膜相关淋巴组织淋巴瘤易位基因1(mucosa-associated lymphoid tissue lymphoma translocation gene 1,MALT1)易位对胃黏膜相关淋巴组织(mucosa-associated lymphoid tissue,MALT)淋巴瘤免疫微环境及患者预后的影响。方法通过免疫组化染色检测40例胃MALT淋巴瘤患者石蜡活检样本中CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、Foxp3^(+)调节性T细胞(Treg)、CD68^(+)巨噬细胞、CD163^(+)M2型巨噬细胞、CD83^(+)树突状细胞(dendritic cell,DC)、CD56^(+)自然杀伤细胞(natural killer cell,NK)和CD33^(+)髓源抑制细胞(myeloid-derived suppressor cells,MDSC)的浸润情况。利用HE染色对患者HP感染情况进行判定,同时采用FISH检测40例胃MALT淋巴瘤中MALT1基因易位情况,根据HP感染和MALT1基因易位情况进行分组,比较免疫微环境及患者预后的差别。结果40例胃MALT淋巴瘤中HP感染阳性率为80%(32/40)。FISH技术鉴定MALT1基因易位阳性率为7.5%(3/40)。9种免疫细胞浸润水平的对比分析中HP阴性组CD4^(+)T细胞浸润水平显著高于HP阳性组(78.73/HPF vs 40.42/HPF,P<0.001),而MALT1易位阳性组CD56^(+)NK浸润水平(2.76/HPF vs 5.58/HPF,P<0.05)显著低于MALT1易位阴性组。HP阴性组患者的无进展生存率显著低于HP阳性组(P<0.05)。结论HP阴性组中CD4^(+)T细胞浸润水平显著高于HP阳性组,且可能与患者预后相关;MALT1易位阳性组中CD56^(+)NK细胞浸润水平显著低于易位阴性组,提示MALT1易位可能影响以NK细胞为代表的部分先天免疫。

25例胃淋巴瘤的CT征象分析

【目的】总结胃淋巴瘤的CT表现特征,以提高CT对胃淋巴瘤的诊断价值。【方法】回顾性分析经病理证实的25例胃淋巴瘤的CT表现,包括胃受累的部位、病灶大体形态、侵犯范围、胃壁厚度、浆膜及胃周脂肪间隙受累情况、强化方式、坏死、其他器官受累、淋巴结肿大情况,并将CT征象与病理类型进行对照分析。【结果】本组25例胃淋巴瘤病人,均为非霍奇金氏淋巴瘤。大多数发生在胃窦(18/25,72%)和胃体(19/25,76%)。胃壁不均匀增厚,最厚处胃壁厚度为7mm～60mm,平均(21.3±12.9)mm,累及范围均大于胃全周的75%。22例(88%)患者病变呈中度均匀强化(与周围肌肉强化程度相近)。21例(84%)有腹腔淋巴结肿大,13例(52%)有肾门下腹膜后淋巴结肿大。绝大多数(19/25,76%)病例合并脾肿大。坏死及溃疡少见,分别只有1例(4%)。3例(3/25,12%)见胃周围侵犯。胃黏膜相关边缘带B细胞淋巴瘤与其他类型淋巴瘤比较,其CT征象具有一定特点,表现为较少累及胃窦,胃壁增厚程度较轻,上述差别均有统计学意义。【结论】胃淋巴瘤的CT表现具有一定特征性,而且,胃黏膜相关性边缘带B细胞淋巴瘤的CT征象有与其他类型胃淋巴瘤不同的特点,CT对于胃淋巴瘤的诊断和鉴别诊断有一定的帮助。

原发性胃恶性淋巴瘤的临床X线诊断(附20例报告)

目的 探讨原发性胃恶性淋巴瘤的双对比X线征象。材料与方法 对经上消化道双对比造影的 2 0例原发性胃恶性淋巴瘤的X线表现 ,从病变形态、大小、数目、部位及范围、胃腔胃壁及功能改变、胃粘膜皱襞改变等方面进行分析。结果 胃粘膜皱襞异常肥大 12例 (60 % ) ,多结节 6例 (3 0 % ) ,不规则浅大溃疡 4例 (2 0 % ) ,巨大软组织块影 2例 (10 % ) ,多种形态病灶并存 14例(70 % ) ;病变大小超过 5cm者 16例 ,占 80 % ;呈多发者 18例 (90 % ) ;胃壁增厚变僵 18例 (90 % ) ,胃蠕动减弱但存在者 2 0例 (10 0 % ) ;胃腔明显缩小狭窄仅 1例 (5 % )。结论 病变的多形性、多灶性、弥漫性及范围广泛 ,胃壁增厚但保持一定的柔软性和蠕动为原发性胃恶性淋巴瘤的重要X线征象 ,且X线与临床表现的严重程度常不成比例。上消化道双对比造影对本病的术前诊断具有较大价值。

多层螺旋CT动态强化扫描诊断原发性胃恶性淋巴瘤

目的 应用多层螺旋CT动态强化扫描探讨其对原发性恶性胃淋巴瘤患者的价值。方法 通过对12例胃淋巴瘤病人进行动态强化扫描,分别对各病例进行诊断。结果 所有病人分为局限性肿块型、弥漫浸润型和溃疡型,其中局限性肿块型6例,弥漫性浸润型3例,溃疡型3例。本组诊断准确性为75%。结论 多层螺旋 CT动态强化扫描在原发性胃淋巴瘤的诊治中具有独特的优越性。

浸润型胃淋巴瘤和浸润型胃癌的多层螺旋CT表现

目的分析浸润型胃淋巴瘤(LGL)和浸润型胃癌(LGC)的多层螺旋CT表现,提高其鉴别诊断水平。资料与方法回顾性分析经病理证实的17例LGL和22例LGC的CT资料。结果病变部位、范围:LGL累及胃底11例,胃体12例,胃窦10例;LGC累及胃底6例,胃体13例,胃窦20例;同时累及2个或2个以上部位:LGL11例,LGC13例。病灶侵犯胃周径>50%者LGL12例,LGC15例,差异无统计学意义(P>0.05)。胃壁厚度:LGL为(24.4±12.1)mm,LGC为(17.7±3.2)mm,差异有统计学意义(P<0.05)。密度及强化:LGL密度均匀15例,三期增强主要呈均匀轻中度强化;LGC密度均匀12例,密度不均匀伴坏死10例;不均匀强化17例。黏膜:LGL仅1例病变处见深溃疡形成;LGC中14例见溃疡形成。胃腔改变:LGL胃壁僵硬2例;LGC胃壁僵硬、胃腔狭窄17例,差异有统计学意义(P=0.000)。胃周肿大淋巴结:胃周2个区以上淋巴结肿大者LGL7例,LGC2例,差异有统计学意义(P<0.05)。结论多层螺旋CT三期动态增强扫描对诊断LGL和LGC具有较高的临床价值。

对比进展期胃癌与原发性胃淋巴瘤中上腹淋巴结转移的CT表现

目的探讨进展期胃癌(AGC)与原发性胃淋巴瘤(PGL)中上腹淋巴结转移的CT表现差异。方法回顾性分析经病理证实且有中上腹淋巴结转移的61例AGC和17例PGL患者的中上腹CT表现,对比分析转移淋巴结的部位、大小、数目、形态、密度及强化方式。结果 AGC中上腹淋巴结转移以肝胃韧带(44/61,72.13%)、贲门周围(28/61,45.90%)、腹腔干周围(27/61,44.26%)、胃结肠韧带(18/61,29.51%)和肝十二指肠韧带及胰头周围(18/61,29.51%)发生率较高,PGL则以肝胃韧带(15/17,88.24%)、肝十二指肠韧带及胰头周围(9/17,52.94%)、胃结肠韧带(8/17,47.06%)、腹腔干周围(8/17,47.06%)和腹主动脉周围下部(8/17,47.06%)发生率较高;PGL腹主动脉周围下部淋巴结转移率较高(χ2=4.606,P=0.032),转移淋巴结最大短轴径(MSAD)≥2.5cm的比例高于AGC,强化较均匀,坏死少见(P均<0.001)。结论与AGC相比,PGL更易引起腹主动脉周围下部淋巴结肿大,MSAD≥2.5cm的淋巴结比例较高,强化较均匀而坏死较少。

胃原发性恶性淋巴瘤的多层螺旋CT诊断

目的:探讨原发性恶性胃淋巴瘤的多层螺旋CT(MSCT)表现特点,提高其诊断水平。材料和方法:回顾性分析14例经病理证实的胃原发性恶性淋巴瘤的MSCT表现,包括病变部位、胃壁及黏膜改变。结果:肿瘤呈弥漫浸润型6例,节段溃疡型4例和肿块型4例。CT示平扫肿瘤密度均匀10例,不均匀4例,CT增强扫描示病灶呈轻、中度均质增强10例,溃疡形成后增强不均匀4例。结论:MSCT扫描能显示对原发性胃淋巴瘤的特点并对其诊断具有重要价值。

能谱CT定量参数鉴别诊断原发性胃淋巴瘤和胃癌

目的探讨能谱CT(GSI)定量参数鉴别诊断原发性胃淋巴瘤(PGL)和胃癌(GC)的价值。方法收集PGL患者16例(PGL组)、GC患者24例(GC组),行平扫和GSI双期增强扫描。测量两组肿瘤病灶的单能量CT值、碘(水)基物质浓度和有效原子序数(Z_(eff)),计算标化碘浓度(NIC)、能谱曲线斜率(λ_(HU))、标化原子序数(Z_(eff-c))。采用独立样本t检验对各定量参数进行比较分析,运用ROC曲线评估其诊断效能。结果 PGL组增强双期40~90keV图像λ_(HU)均低于GC组(t=2.90、3.69,P=0.008、0.001)。PGL组动脉期40keV、静脉期40~120keV单能量CT值均低于GC组(P均<0.05);PGL组70keV增强双期NIC、动脉期标化水浓度均低于GC组,PGL组静脉期Z_(eff-c)高于GC组(P均<0.05);静脉期70keV单能量图像以λHU=2.63mg/cm3为阈值鉴别诊断PGL和PC的敏感度和特异度分别为62.5%和100%。结论GSI定量参数对PGL和GC的鉴别诊断有一定实用价值。

胃粘膜相关淋巴组织型淋巴瘤形态学研究

目的：研究胃粘膜相关淋巴组织（ＭＡＬＴ）型淋巴瘤及其与胃粘膜套细胞淋巴瘤和滤泡性淋巴瘤的鉴别诊断。方法：应用ＨＥ染色和免疫组化ＡＢＣ法检测胃ＭＡＬＴ型淋巴瘤，内镜作幽门螺杆菌（ＨＰ）培养或尿素试验检测ＨＰ感染。结果：３１例胃ＭＡＬＴ型淋巴瘤中低度恶性２７例，高度恶性４例。细胞类型以ＣＣＬ型最常见。免疫表型以ＩｇＭ为主，缺乏ＩｇＤ。３１例中２８例有ＨＰ感染（占９０．５２％）。结论：①低恶ＭＡＬＴ型淋巴瘤常见到淋巴上皮病变，滤泡性克隆化和反应性滤泡，具有诊断和鉴别诊断价值。②高恶ＭＡＬＴ型淋巴瘤伴有低恶成分。

胃间质瘤与原发性胃淋巴瘤的CT征象及鉴别诊断

目的探讨胃间质瘤(GST)与原发性胃淋巴瘤(PGL)的CT表现及鉴别诊断。资料与方法纳入经病理证实的26例GST患者和21例PGL患者,观察CT图像所示病变部位、数目、范围、与邻近胃壁的关系、密度、强化特征、黏膜及浆膜情况、胃周淋巴结及其他器官侵犯。结果 26例GST患者均为单发局限性肿块,位于胃底17例,胃体部9例,与邻近胃壁界限清;21例PGL患者均有不同程度的弥漫胃壁增厚,与邻近胃壁界限不清或相延续。CT平扫示GST为均匀等或稍低密度,或不均匀等低混杂密度,实性部分平均CT值为(32±11)Hu;PGL呈均匀等密度,平均CT值为(52±9)Hu,两者差异有统计学意义(t=12.37,P<0.05)。增强扫描示GST呈均匀、不均匀明显延迟强化,而PGL呈轻度均匀延迟强化,门静脉期GST与PGL强化程度差异有统计学意义(t=5.35,P<0.05)。26例GST患者病变处浆膜层光滑清晰,无一例见胃周淋巴结肿大;PGL病变处浆膜层模糊2例,19例浆膜层光滑清晰;6例PGL见胃周淋巴结肿大。结论 GST病变局限、CT呈不均匀低密度并不均匀明显强化;PGL病变相对弥漫、CT呈均匀等密度并轻度均匀强化,有助于两者的诊断及鉴别诊断。

原发性胃淋巴瘤的多层螺旋CT诊断价值

目的探讨原发性胃淋巴瘤的多层螺旋CT表现特征及诊断价值。方法对11例经病理证实的原发性胃淋巴瘤患者的多层螺旋CT及临床资料进行回顾分析。结果 11例均为B细胞起源非霍奇金淋巴瘤。原发性胃淋巴瘤按CT表现分为弥漫增厚型、节段增厚型、局限增厚型及混合型,CT表现特征主要有:①多灶分布和广泛、显著胃壁增厚;②病变沿长轴侵犯有一定柔软度,胃腔无明显变形;③病变区胃浆膜面多清楚,胃周脂肪无明显受侵;④胃粘膜广泛粗大伴多发的浅溃疡。结论原发性胃淋巴瘤的多层螺旋CT表现特征对诊断和鉴别诊断有一定价值。