Gastric adenocarcinoma with lymphoid stroma. About nine cases

Aim : the purpose of this work is to study the pathological features and the outcome of lymphoid stroma gastric carcinoma and its relation with Epstein-Bar Virus (EBV) and the imortance of the EBV serology in detection of early reccurence. Methods : between January 1990et december 2004, 155 patients underwent gastric resection for gastric carcinoma. Nine of them had lymphoid stroma gastric carcinoma. Over all survival as well as disease free survival were determined. Detection of reccurence was based on clinical exam and on findings yielded by endoscopy, radiological exams and EBV serology. A comprison of survival rate of patients beteween current gastric carcinoma and those with lymphoid stroma gatsric carcinoma was done using the Log Rank test. Results: the patients (7 men and 2 women) had a mean age of 61 years (41 to 82). The tumor was in the antrum in 4 cases, in the body of the stomach in 3 cases and in the cardia in 2 cases. The mean tumor size was 8 cm with deep invasion of the stomach wall in 5 cases and ganglionnary invasion in 6 cases out of 9. EBV was detected in all patients by in situ hybridation. Post operative morbidity and mortality were nil. Global survival and disease free survival were, respectively, 53.3 % and 65.6 % in lymphoid stroma gatsric carcinoma, and 43.4 % and 63.5 % for current gatsric carcinoma. Three patients died of a reccurent disease after 6,30 and 33 months. The remaing 6 patients didn't have signs of reccurence. Conclusion: lymphoid stroma gastric carcinoma is a bulky, local disease. In our patients, it was always associated with EBV. Over all survival was better than survival of current gastric carcinoma, although there was no significance. EBV serology can be an effective scrennign procedure of reccurence.