The diagnosis of a lymphosarcoma which originates in the stomach is seldom made preoperatively; rarely is it even correctly identified at the operating table. Of 22 cases of gastric lymphosarcoma reviewed in the April issue of the Archives of Surgery,1 13 were reticulum-cell sarcoma, four were lymphocytic lymphosarcoma, mature-cell type, and three were Hodgkin's granuloma. Plasmacytoma and macrofollicular lymphoma accounted for one each. Striking was the frequent lack of cachexia and anemia in patients with large tumors. Further, only two patients had roentgenographic findings suggestive of sarcoma, and in only two instances was sarcoma identified at surgery by frozen section.
Review of the preoperative x-rays of these patients indicates that certain features should strongly suggest gastric lymphosarcoma: a large area of mucosal irregularity with a "corrugated" or "cobblestone" appearance; a giant ulcer; or multiple widespread ulcerated or nodular mucosal deformities. The gross appearance of these tumors varies, but certain