GIST and Lymphoma
GIST and Lymphoma: Types of Stomach Cancer
GIST (Gastrointestinal Stromal Tumor):
GIST is a type of tumor that most commonly develops in the stomach, though it can also arise in the small intestine, rectum, or esophagus.
Symptoms / Clinical Presentation:
- Sometimes found accidentally during endoscopy or CT scan
- Vomiting blood or passing black, tarry stools (GI bleeding)
- Abdominal pain
- Symptoms of blockage such as difficulty swallowing, repeated vomiting, abdominal swelling, or severe abdominal pain
Diagnosis:
Tests used to diagnose and plan treatment include:
- Endoscopy and endoscopic ultrasound
- Contrast-enhanced CT scan (CECT) of the abdomen
- PET scan to detect distant spread
Treatment:
- Small GISTs can be monitored regularly
- Large tumors without spread should be surgically removed
- Tumors that cannot be removed or patients who cannot undergo surgery are treated with targeted medicines like imatinib or sunitinib
Gastric Lymphoma:
Gastric lymphoma accounts for about 3–5% of stomach cancers. The stomach is the most common site where lymphoma appears outside the lymph nodes.
Marginal Zone B-Cell (MALT) Lymphoma:
This is the most common type of stomach lymphoma. It is usually linked to long-term H. pylori infection, which causes chronic gastritis.
Symptoms:
- Indigestion
- Pain in the upper abdomen
- Nausea, vomiting, feeling full early
- Gastrointestinal bleeding
- Fever and weight loss
Diagnosis:
- Detected via endoscopy, which may show redness, erosions, ulcers, or a visible growth
- Biopsies are taken for confirmation
- CT scan and EUS help determine the stage and spread of the disease
Treatment:
- Early-stage disease can often be cured by treating H. pylori
- Advanced cases require chemotherapy
Diffuse Large B-Cell Lymphoma:
The role of H. pylori in this type is still uncertain.
Symptoms:
- Upper abdominal pain and indigestion
- Large tumors may cause blockage
- Ulcers can bleed
Diagnosis:
- Upper GI endoscopy with biopsy
- Endoscopy often shows a large tumor or ulcer in the body or antrum of the stomach
- CT, PET scan, and EUS are used for staging
Treatment:
Chemotherapy, sometimes combined with radiotherapy, is the main form of treatment