PubMed1982
The authors report three cases of gastric pseudolymphoma, before going on to review the literature on the subject. The pseudolymphoma has only recently been identified in relation to other primitive gastric lymphoid growths, on the basis of histological and evolutional criteria, which show it to be benign. It raises two problems. Firstly, a practical problem of diagnosis, as it often visualizes radiologically and endoscopically as a malignant tumor, and this diagnostic uncertainty persists, even after endoscopic biopsy. This necessarily implies surgical management of the case, normally leading to a clear diagnosis based on study of the gastrectomy specimen. Histologically, a growth of this nature consists of a very large lymphoid hyperplasia, often of an organoid type, strictly confined to the mucosa, which, incidentally, shows no real recent or ancient ulceration. Cytologically, this lymphoid infiltrate is benign and the neighbouring nodes are always normal. Point by point, therefore, these characteristics distinguish the pseudolymphoma from the real lymphoma and the lymphoid hyperplasia associated with ulcers. Fluorescence microscopic study of the intracytoplasmic immunoglobulin, which was carried out in the cases treated by the authors, and also in another recent case reported in the literature, shows a polyclonal type immunofluorescence. The pseudolymphoma is therefore, a benign form of lymphomatosis without ulceration. The second problem concerns the real nature of the lesion: a local immunosuppressive pathology? An atypical lymphoid presarcomatous hyperplasia? In order to support these hypotheses, fresh tissue lymphocyte typing tests covering the entire field of digestive lymph pathology should be carried out to complete the intracytoplasmic immunofluorescent study of the immunologically competent cells.