[Gastrointestinal lymphomas].

Abstract

Based on new insights into aetiology and pathogenesis of gastrointestinal lymphomas and their histomorphological and molecular characteristics, important progress in their diagnostics and therapy has been made during recent years. The WHO has established an internationally accepted classification of gastrointestinal lymphomas. Although not considered therein, from the clinical point of view a differentiation between low- and high-grade lymphomas would seem to be helpful as the grade of malignancy and stage directly determine the therapeutic strategy. Therefore, a thorough endoscopic-bioptic technique (gastric mapping) and careful clinical staging is necessary. The latter should always include endoscopic ultrasound. Helicobacter pylori represents the decisive causal factor for gastric MALT lymphomas while untreated sprue is an established risk factor for intestinal T cell lymphomas. The therapeutic spectrum ranges from Helicobacter pylori eradication therapy to the well known oncological modalities, namely chemotherapy, radiation or surgery and their combined use. However, also a watch-and-wait strategy may be a good choice in the individual case (minimal residual disease after successful Helicobacter pylori eradication or disseminated stages of indolent lymphomas not offering a curative option).