위장의 점막 연광성 림프조직 림프종(MALT Lymphoma)의 임상적 고찰
Clinical Analysis of MALT Lymphoma in the Stomach
백광열, 노재형, 허진석, 손태성, 최성호, 조재원, 김성, 김용일,
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백광열 ( Paik Kwang-Yeol )
성균관대학교 의과대학 삼성서울병원 외과
노재형 ( Noh Jae-Hyung )
성균관대학교 의과대학 외과학교실
허진석 ( Heo Jin-Seok )
성균관대학교 의과대학 삼성서울병원 외과학교실
손태성 ( Sohn Tae-Sung )
성균관대학교 의과대학 외과학교실
최성호 ( Choi Seong-Ho )
성균관대학교 의과대학 외과학교실
조재원 ( Cho Jae-Won )
성균관대학교 의과대학 삼성서울병원 외과학교실
김성 ( Kim Sung )
성균관대학교 의과대학 외과학교실
김용일 ( Kim Yong-Il )
성균관대학교 의과대학 외과학교실
KMID : 0371320020620060468
Abstract
Purpose: The aim of our study was to analyze the clinical and histopathological characteristics of mucosa associated lymphoid tissue (MALT) lymphoma in the stomach.
Methods: We retrospectively reviewed the medical records of 22 patients with pathologically proven MALT lymphoma from Jan. 1995 to Sep. 2000 in Samsung Medical Center. The factors analyzed were operative procedures, tumor stage and
histopathological characteristics.
Results: Of 3658 patients with gastric malignancy, 22 (0.6%) patients, 7 men and 15 women from 25 to 70 years (mean, 48.8 years), were found to have MALT lymphoma. Fourteen cases (64%) were located in the antrum, 4 (18%) in the body and 4
(18%)
in the fundus or the high body. Nineteen patients were managed with total gastrectomy and splenectomy, and 3 with radical subtotal gastrectomy. Histopathologically, the tumor was limited to the mucosa in 3 patients (13.6%), to the submucosa in 13
(59.1%), and extended to the muscularis propria in 6 (27.3%). The lymph node involvement was seen in 12 patients (54.6%). There were no cases of splenic, hepatic or bone marrow involvement. H. pylori was identified in 11 patients (50%). During the
mean
follow-up period of 32.7 months, there were no reports of tumor recurrence or death.
Conclusions: MALT lymphoma rarely disseminates at the time of diagnosis and rarely involves the bone marrow. Lymph node involvement, however, was relatively high. Total gastrectomy is effective in the management of patients with high grade
MALT
lymphoma and adjuvant chemotherapy is effective in cases of metastasis.
키워드
점막연광성 림프조직 림프종; 위; Mucosa associated lymphoid tissue (MALT) lymphoma; Stomach;
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