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Klassifikation und Stadieneinteilung gastrointestinaler Lymphome

Classification and staging of gastrointestinal lymphomas

  • Themenschwerpunkt: Therapiekonzepte Bei Hodgkin- Und Non-Hodgkin-Lymphomen Des Gastrointestinaltraktes
  • Published:
Acta chirurgica Austriaca Aims and scope Submit manuscript

Zusammenfassung

Grundlagen: Der Gastrointestinaltrakt ist die häufigste Lokalisation primär extranodaler Lymphome. Gastrointestinale Lymphome leiten sich zum überwiegenden Teil vom mukosaassoziierten lymphatischen Gewebe (MALT) ab und zeigen einen klinischen Verlauf, der sich deutlich von nodalen Lymphomen unterscheidet.

Methodik: Die Klassifikation gastrointestinaler Lymphome beruht auf der histologischen Untersuchung der Präparate. In der Regel sind dazu neben Routinefärbungen auch immunhistochemische Untersuchungen und zum Teil auch molekularpathologische Nachweismethoden notwendig. Zur Stadieneinteilung ist neben der exakten pathohistologischen Diagnose die genaue Kenntnis der Ausbreitung notwendig.

Ergebnisse: Durch gezielten Einsatz endoskopisch-bioptischer und sonographischer Untersuchungstechniken ist die Gewinnung repräsentativen Untersuchungsmaterials möglich. Operationspräparate müssen vom Pathologen exakt aufgearbeitet werden. Dies ist die Voraussetzung für eine rationelle Anwendung histologischer, immunhistochemischer und molekularpathologischer Untersuchungsmethoden, die eine rasche und eindeutige Diagnosestellung und Klassifikation sowie eine exakte Stadieneinteilung ermöglichen.

Schlußfolgerungen: Eine exakte Klassifikation und Stadieneinteilung ist die Grundlage einer adäquaten patientenspezifisch maßgeschneiderten Therapie.

Summary

Background: The gastrointestinal tract is the most common localization of primary extranodal lymphomas. Most gastrointestinal lymphomas are derived from the mucosa-associated lymphoid tissue (MALT) and show a course markedly different from nodal lymphomas.

Methods: Classification of gastrointestinal lymphomas is based on histologic examination. As a general rule, immunohistological and sometimes also molecular diagnostic methods are necessary to supplement routine stains in most cases. For staging purposes, exact knowledge of dissemination is necessary in addition to the pathohistological diagnosis.

Results: Using endoscopy, biopsy and sonography representative tissue can be obtained. Large specimens have to be carefully investigated by a pathologist. This is the basis for a rational utilization of histological, immunohistochemical and molecular techniques, allowing prompt and unambiguous diagnosis, classification and exact staging.

Conclusions: Exact classification and staging is the basis for an adequate patient specific tailored therapy.

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  1. Karl-Franzens-Universität Graz, Institut für Pathologie, Karl-Franzens-Universität, Auenbruggerplatz 25, A-8036, Graz, Austria

    G. Höfler

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Höfler, G. Klassifikation und Stadieneinteilung gastrointestinaler Lymphome. Acta Chir Austriaca 30, 265–269 (1998). https://doi.org/10.1007/BF02620105

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