Gut Liver.  2014 Nov;8(6):637-642. 10.5009/gnl13284.

Limited Role of Bone Marrow Aspiration and Biopsy in the Initial Staging Work-up of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma in Korea

• Min BH
• Park JY
• Kim ER
• Min YW
• Lee JH
• Rhee PL
• Rhee JC
• Kim JJ

• KMID: 2070081
• DOI: http://doi.org/10.5009/gnl13284

Abstract

BACKGROUND/AIMS
The aim of this study was to investigate the frequency of disseminated gastric mucosa-associated lymphoid tissue (MALT) lymphoma and the role of bone marrow study in the initial staging work-up.
METHODS
A total of 194 patients with gastric MALT lymphoma was enrolled. The incidence of disseminated disease was evaluated in the initial staging work-up. The demographic data and tumor characteristics were compared according to Helicobacter pylori infection status.
RESULTS
Localized disease of Lugano stage I accounted for 97.4% of the enrolled cases. Abdominal computed tomography revealed abdominal lymph node metastasis in five patients (2.6%). Bone marrow (BM) involvement was found in only one patient without H. pylori infection (0.5%). No patient showed positive findings on chest computed tomography or positron emission tomography. H. pylori-negative cases showed a significantly higher frequency of advanced-stage disease than H. pylori-positive cases (10.0% vs 0.6%). In patients achieving complete remission, no extragastric recurrence occurred during follow-up.
CONCLUSIONS
The incidence of disseminated disease, including BM involvement, was very low in Korean gastric MALT lymphoma patients. It might be beneficial to perform BM aspiration and biopsy as a part of staging work-up only in patients with risk factors for advanced disease such as H. pylori negativity.

Keyword

Lymphoma, B-cell, marginal zone; Stomach; Bone marrow; Staging

MeSH Terms

Abdomen
Adult
Aged
Bone Marrow/*pathology
Bone Marrow Examination
Cohort Studies
Female
Helicobacter Infections/*complications
Humans
Lymph Nodes/*radiography
Lymphoma, B-Cell, Marginal Zone/complications/*pathology
Male
Mediastinum/radiography
Middle Aged
Neoplasm Staging
Radiography, Abdominal
Republic of Korea
Retrospective Studies
Stomach Neoplasms/complications/*pathology
Tomography, X-Ray Computed