ENDOSCOPIC FEATURES IN PATIENTS WITH MARGINAL ZONE LYMPHOMA OF MUCOSA ASSOCIATED LYMPHOID TISSUE (MALT) IN A FOLLOW UP OF 10 YEARS 1 N.V. Chrysanthos, 1 S. Patsavela, 1 E. Anagnostopoulou, 2 A. Kolovou, 2 K. Palla, 3 A. Papanikolaou 1 Gastrointestinal Department, 2 Hematological Department ″St George″ General Hospital Of Chania, 3 Anatomopathological Department Evangelismos Hospital of Athens

Gastrointestinal lymphoma is the most common type of extranodal lymphomas. Most commonly affects the stomach. The incidence of gastric MALT is increasing. Early diagnosis is still difficult, due to its non-specific symptoms and endoscopic findings. Gastric MALT is typically a low grade B-cell neoplasia, strongly associated with H.pylori infection. The diagnosis is made by endoscopic biopsy. Most commonly, its clinical presentation is characterised by non- specific gastrointestinal symptoms (vague dyspepsia, epigastric pain). INTRODUCTION

Early detection and accurate stage work up is essential for treatment. H.p eradication leads to complete regression in most of the cases. Unresponsive patients require other antineoplastic therapeutic approaches (radiotherapy, chemotherapy, or immunotherapy). Recurrence time varies and endoscopic surveillance is needed. INTRODUCTION (cont.)

AIM Endoscopic features of patients with MALT at first diagnosis, recurrence period, and follow up. METHODS It is a retrospective study which includes 18 patients with MALT in the last decade. Data were analyzed with SPSS 21.0.

RESULTS Half of our patients had specific findings [8/18 (44.4%), P: 0.69] Most frequent endoscopic features of the patients at initial diagnosis of ML were: 1.Erythematous gastritis (EG) 2.Erosive gastritis 3.Gastric ulcers

Recurrent disease presented significantly more frequent redness with whitish areas and edema [mucosal atrophy (AG)] [3/10 (30%), P: 0,02] Patients with minimal disease quite frequently exhibited EG and small nodular appearance of the mucosa [5/31 (16%) P:0.25 and 2/31 (6.4%) P:0.46]. Patients with non-active disease frequently had EG [12/40 (30%), P: 0.78] and rarely AG [1/40 (2.5%), P: 0.19]. MALT had a non-predictive biological attitude and could recur years after its first diagnosis. Upper endoscopy with multiple biopsies is the basic follow-up procedure. RESULTS (cont.)CONCLUSIONS

Jeong Bae Park, Ja Seol Koo, ”Helicobacter pylori infection in gastric mucosa-associated lymphoid tissue lymphoma”, World J. Gastroenterology 2014 March 21; 20(11):