Linfoma gastrico
Generalità
Il linfoma (5% delle neoplasie gastriche) è la più frequente delle neoplasie non epiteliali maligne dello stomaco. Il più frequente linfoma gastrico è il MALT-linfoma (Mucosal- Aassociated-Lymphoid Tissue), tumore del tessuto linfoide associato alle mucose. Il MALT- linfoma consegue all’infezione da Helicobacter pylori. Ne esistono due varianti morfologiche, cliniche e prognostiche:
- Il linfoma gastrico correlato all’infezione da Helicobacter pylori, a cellule B e a basso grado di malignità, tipico del sesso maschile e dell’età avanzata;
- Il linfoma gastrico ad alto grado.
Sintomi
I sintomi sono aspecifici e comprendono:
- Fatica
- Febbre
- Nausea
- Stitichezza
- Perdita di peso
- Anemia
Altri sintomi riguardano specificamente gli organi affetti:
- Dolore addominale nel caso di un coinvolgimento dello stomaco
- Infezioni polmonari ricorrenti nel caso di un coinvolgimento del polmone
- Compromissione della vista nei casi di coinvolgimento delle ghiandole lacrimali.
- In generale i pazienti non presentano linfadenopatia.
Diagnosi
La diagnosi si fonda sull’ EGDS (Esofagogastroduodenoscopia) associata a biopsie su lesioni ulcerate o polipoidi.
Terapia
Il trattamento prevede (come prima scelta) l’eradicazione dell’infezione da H. pylori a cui consegue nella maggioranza dei casi una regressione della neoplasia. La chirurgia o la radioterapia si utilizzano nelle localizzazioni unicamente gastriche non responsive all’ eradicazione o nelle quali la H. pylori non è presente. La chemioterapia è indicata in casi con interessamento linfonodale diffuso nei quali trovano indicazione anche anticorpi monoclonali anti linfociti CD20+. Questi linfomi hanno un’evoluzione lenta. Quando un linfoma è isolato, il tasso di sopravvivenza a 10 anni dopo trattamento è circa del 75%.
Articoli correlati:
Linfoma B diffuso a grandi cellule (DLBCL)
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