1. Aliment Pharmacol Ther. 2006 Mar 15;23(6):721-6.Clinical and endoscopic presentation of primary gastric lymphoma: a multicentrestudy.Andriani A, Zullo A, Di Raimondo F, Patti C, Tedeschi L, Recine U, Caruso L,Bonanno G, Chiarenza A, Lizzani G, Miedico A, Romanelli A, Costa A, Linea C,Marrone C, Mirto S, Mistretta A, Montalbano L, Restivo G, Vinci M, Bibas M,Hassan C, Stella F, Cottone M, Morini S.Department of Haematology and Gastroenterology, 'San Giacomo' and 'Nuovo ReginaMargherita' Hospitals, Rome, Italy.BACKGROUND: Although the stomach is the most frequent site of intestinallymphomas, few data are available on both clinical endoscopic presentation ofgastric lymphoma and possible differences between low-grade and high-gradelymphomas.METHODS: Clinical, histological and endoscopic records of consecutive patientswith primary low-grade or high-grade lymphoma diagnosed were retrieved. Symptoms were categorized as 'alarm' or 'not alarm'. The endoscopic findings wereclassified as 'normal' or 'abnormal'.RESULTS: Overall, 144 patients with primary gastric lymphoma were detected,including 74 low-grade and 70 high-grade lymphoma. Alarm symptoms, particularlypersistent vomiting and weight loss, were more frequently present in patientswith high-grade lymphoma than in those with low-grade lymphoma (54% vs. 28%; P = 0.002). Low-grade lymphomas presented as 'normal' appearing mucosa (20% vs. 0%; P= 0.0004) or petechial haemorrhage in the fundus (9% vs. 0%; P = 0.02) morefrequently than high-grade lymphomas, being also more often confined to theantrum (47% vs. 27%, P = 0.03) and associated with Helicobacter pylori infection (88% vs. 52%, P < 0.0001). On the contrary, high-grade lymphomas presented morecommonly as ulcerative type (70% vs. 52%; P = 0.03), being also more frequentlydiagnosed in stage >I when compared with low-grade lymphomas (70% vs. 21%, P <0.0001).CONCLUSIONS: The overall prevalence of alarm symptoms is quite low and may beabsent in more than 70% of patients with low-grade lymphoma.