{"entity":{"id":"lymphoma-lugano-gastrointestinal","kind":"term","name":"Staging a lymphoma of the stomach or bowel","aka":["Lugano staging system for gastrointestinal lymphoma","Paris staging","TNM for gastric lymphoma","stage IE gastric lymphoma"],"tldr":"A lymphoma that starts in the stomach or bowel is staged by how deep it goes into the wall and how far along the lymph node chain it has travelled, not only by how many node regions are involved. The depth is measured by endoscopic ultrasound, and it decides whether antibiotics alone are worth trying.","summary":"Gastrointestinal lymphoma has its own staging vocabulary because the ordinary node-counting system does not capture what matters. The Lugano staging system for gastrointestinal lymphoma, which predates and is separate from the Lugano classification of 2014, runs: stage I, confined to the gut wall; stage II, extending into the abdomen, subdivided by whether the involved nodes are local (II-1) or distant (II-2); stage IIE, penetrating the serosa to involve adjacent organs; stage IV, disseminated or with supradiaphragmatic nodes. A parallel system, the Paris staging system, maps the same disease onto TNM-style depth categories (T1 mucosa and submucosa, T2 muscularis propria, T3 serosa, T4 adjacent structures).\n\nWhy the depth matters. In gastric marginal zone lymphoma of mucosa-associated lymphoid tissue, antibiotic eradication of Helicobacter pylori is the whole of the first treatment, and it works best in disease confined to the mucosa and submucosa. Endoscopic ultrasound measures that depth directly, and in a prospective series it assessed the depth of infiltration correctly in 91.5 per cent of cases against the resected specimen, while being less reliable about how far the tumour spread across the surface.\n\nWhat the staging does not decide. Surgery has no routine role in gastric lymphoma at any stage, which is the main thing that separates it from gastric adenocarcinoma, and a stage that would mean an operation in a carcinoma does not mean one here.","asOf":"2026-09-29","links":[{"label":"Lugano classification: recommendations for initial evaluation, staging and response assessment of Hodgkin and non-Hodgkin lymphoma (Cheson, J Clin Oncol 2014)","url":"https://doi.org/10.1200/JCO.2013.54.8800"},{"label":"Endoscopic ultrasonography in the local staging of primary gastric lymphoma (Endoscopy 1993)","url":"https://doi.org/10.1055/s-2007-1010385"}],"tags":["heme","lymphoma"],"related":["lugano-classification","endoscopic-ultrasound-systems","lymphoma-nodal-versus-extranodal"],"cancers":["malt-lymphoma","marginal-zone-lymphoma","non-hodgkin-lymphoma"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Clinical"},"route":"/terms/lymphoma-lugano-gastrointestinal/","neighbours":{"term":[{"id":"lugano-classification","kind":"term","name":"Lugano classification / Ann Arbor staging","route":"/terms/lugano-classification/"},{"id":"lymphoma-nodal-versus-extranodal","kind":"term","name":"Nodal and extranodal lymphoma","route":"/terms/lymphoma-nodal-versus-extranodal/"}],"technology":[{"id":"endoscopic-ultrasound-systems","kind":"technology","name":"Endoscopic ultrasound and EBUS systems","route":"/technologies/endoscopic-ultrasound-systems/"}],"cancer":[{"id":"enteropathy-associated-t-cell-lymphoma","kind":"cancer","name":"Enteropathy-associated T-cell lymphoma","route":"/cancers/enteropathy-associated-t-cell-lymphoma/"},{"id":"malt-lymphoma","kind":"cancer","name":"Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma)","route":"/cancers/malt-lymphoma/"},{"id":"gastric-malt-lymphoma","kind":"cancer","name":"Gastric MALT lymphoma","route":"/cancers/gastric-malt-lymphoma/"},{"id":"marginal-zone-lymphoma","kind":"cancer","name":"Marginal zone lymphoma","route":"/cancers/marginal-zone-lymphoma/"},{"id":"monomorphic-epitheliotropic-intestinal-t-cell-lymphoma","kind":"cancer","name":"Monomorphic epitheliotropic intestinal T-cell lymphoma","route":"/cancers/monomorphic-epitheliotropic-intestinal-t-cell-lymphoma/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"}]}}