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GIST and Lymphoma
GIST (Gastrointestinal stromal tumor)
Stomach is the most common site for the GIST, other sites include small intestine, rectum, and esophagus
Clinical presentation
- Asymptomatic lesion detected during endoscopy or CT scan
- GI bleed in the form of hemetemesis and black colored stools
- Abdominal pain
- Obstructive features such as dysphagia, recurrent vomiting, abdominal distension, and severe pain abdomen
Diagnosis
Following test are required for diagnosis and management
- Endoscopy and endoscopic ultrasound
- CECT abdomen
- PET scan to rule out distant metastasis
Treatment
- Small GIST can be followed up
- Large tumor without metastasis should be operated
- Unresectable tumors, and in patients where surgery is not feasible, are best treated by chemotherapy with imatinib and sunitinib
Gastric Lymphoma
Gastric lymphoma constitute 3-5 % of all gastric tumors. Stomach is the most common extranodal site of lymphoma.
Marginal zone B cell lymphoma of stomach
Marginal zone B cell lymphoma, also known as MALT lymphoma is the most common lymphoma of stomach, chronic H pylori infection leading to chronic gastritis is the underlying cause.
Clinical features
- Dyspepsia
- Epigastric pain
- Nausea, vomiting and early satiety
- GI bleeding
- Fever, vomiting and weight loss
Diagnosis
- Lesions are usually diagnosed by endoscopy, endoscopic findings are
- Erythema
- Erosions
- Ulcers
- Growth.
- Biopsy is taken from the suspicious areas
- CT and EUS are the investigations required for evaluation of extent of diseases and metastasis
Treatment
- Early state of disease can be treated by eradication of H Pylori
- Advanced disease is treated by chemotherapy
Diffuse large B cell lymphoma
- The role of H pylori in the pathogenesis is not very clear
- Clinical symptoms
- Epigastric pain and dyspepsia
- Large tumor may cause obstruction
- Ulcerated lesion may bleed
Diagnosis
- Upper GI endoscopy and biopsy are required for the diagnosis
- Endoscopic findings are large tumor and ulcer
- Body and antrum are common sites
- CT/PET and EUS are done for staging
Treatment
Chemotherapy with or without radiotherapy is mainstay of treatment
Reviews
I have come across Dr Vikas post lots of research via internet,going through the various feedbacks& I hope my feedback will help anybody who is in dilemma in selecting right doctor.Without a doubt he is one of the top doctors in GI.
Dr Vikas is one of the wonderful,gentle&talented doctor I have come across,he provides the correct direction &also helps in clearing all the doubts/concerns. Moreover his attendent is also very helpful& will heIp you in all possible way.I am very pleased on the overall experience & highly recommend.Thanks doctor for you wonderful support in all ways.May God bless you more & keep on giving great service !!!
Catherine
Dear DGOC
Dr Vikas Singla and team is a very good, nice and soft spoken today 22 Feb we attend a camp for full lever checkup very good service and well maintained every things we wish a very good luck to Dr Vikas Singla and team (Amit)
Gaurav khare
The best doctor i ever met. A very cordial person in nature and very talented doctor. He is a good person to talk and have advice. I was suffering from gastritis for last 2 years. I had consulted 2 to 3 doctors but did not see any sign of improvement. I almost lost my hope to get relief from this disorder. I thought this is something I will have to endure with. But doctor Singhla treated it very well with patience and now i am feeling much much better. Thanks DR. Vikas for treating my disorder.
Ankit sharma
I am at loss for words in describing Dr Singla’s dedication towards his patients. Last month my father was treated by him for gastric polyps. His forte lies in listening to the patients and putting across the problem in a comprehensive manner. He was also very prompt in diagnosing the problem and comping up with the solution which speaks for his experience and expertise in his field. By God’s grace and through his treatment my dad is recovering. I value his professional opinion and will forever remain grateful to him. He surely is the best Gastroenterology in North India.
Ojaswita
Best and thorough The one who is incredible in doing hard and difficult procedures With smiling face and human touch Proud of U dear teacher.