Patients with gastric MALT lymphoma revealing persisting endoscopic abnormalities after successful eradication of Helicobacter pylori can be safely managed by a watch-and-wait strategy

2019 ◽  
Vol 57 (05) ◽  
pp. 593-599
Author(s):  
Wolfgang Fischbach ◽  
Christian Dorlöchter
Keyword(s):  
Helicobacter Pylori ◽  
Malt Lymphoma ◽  
Single Case ◽  
Gastric Malt Lymphoma ◽  
Complete Regression ◽  
Watch And Wait ◽  
Oncological Treatment ◽  
First Line Therapy ◽  
Diffuse Atrophy ◽  
H Pylori

Abstract Background In current guidelines, Helicobacter pylori eradication is recommended as first-line therapy in patients with gastric MALT lymphoma. This leads to complete lymphoma regression in the majority of patients. Those who show persisting histological residuals of lymphoma after eradication of the bacterium and normalization of endoscopic findings are managed by a watch-and-wait strategy. We aim to show that such an approach can be extended to patients with persisting endoscopic abnormalities. Methods Thirteen patients (7 female and 6 male; 62 years, range: 43 – 80) with gastric MALT lymphoma of stages I and II1 had received exclusive H. pylori eradication. Control endoscopies performed every 3 – 4 months during the first 2 years and 6 and 12 times monthly 2 – 5 and > 5 years after diagnosis, respectively, revealed successful eradication of H. pylori but persisting endoscopic abnormalities. Histologically, complete regression of the lymphoma or minor residuals were observed. Results Persisting endoscopic changes included thickened folds with or without superficial erosions, nodular mucosal surface with or without angiectasia, focal or diffuse atrophy, focal erythema, or a mixture of these findings. During a follow-up of 89.9 (12 – 329) months, the outcome of these patients was excellent with no single case of lymphoma progression. Conclusion A watch-and-wait strategy can be recommended for patients with gastric MALT lymphoma showing persisting endoscopic abnormalities after eradication of H. pylori. There is no need for any oncological treatment provided that regular endoscopic-bioptic controls do not reveal any progressive changes. A standardized description of the endoscopic changes as well as a thorough bioptic technique should be included.

scholarly journals Gastric MALT lymphoma refractory to Helicobacter pylori antibiotic therapy

2019 ◽  
Vol 7 ◽  
pp. 2050313X1986947
Author(s):  
Charlene L Rohm ◽  
Sara Acree
Keyword(s):  
Helicobacter Pylori ◽  
B Cell ◽  
Lymphoid Tissue ◽  
Epigastric Pain ◽  
Gastric Malt Lymphoma ◽  
Histopathologic Examination ◽  
Oncological Treatment ◽  
First Line Therapy ◽  
Genetic Abnormalities ◽  
H Pylori

Gastric mucosa-associated lymphoid tissue lymphoma is a rare clonal B-cell neoplasm that is usually associated with Helicobacter pylori infection. The presence of H. pylori should be confirmed via special stains and/or immunohistochemistry of gastric biopsies from multiple anatomic sites of the stomach. Mucosa-associated lymphoid tissue lymphoma is diagnosed with histopathologic examination and positive immunohistochemical staining for certain B-cell markers. Ancillary testing should be performed to determine any genetic abnormalities in H. pylori that increases its virulence. We report the case of a 49-year-old woman with recurrent epigastric pain and vomiting found to have chronic H. pylori gastritis despite appropriate rounds of treatment with first-line therapy. She was diagnosed with mucosa-associated lymphoid tissue lymphoma via histopathologic examination. She ultimately required oncological treatment due to H. pylori infection refractory to antibiotic treatment.

scholarly journals MALT lymphoma: epidemiology, clinical diagnosis and treatment

2018 ◽  
Vol 11 (3) ◽  
pp. 187-193 ◽  
Author(s):  
Petruta Violeta Filip ◽  
◽  
Denisa Cuciureanu ◽  
Laura Sorina Diaconu ◽  
Ana Maria Vladareanu ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
B Cell ◽  
Malt Lymphoma ◽  
Cell Lymphoma ◽  
Gastric Lymphoma ◽  
Eradication Therapy ◽  
B Cell Lymphoma ◽  
Gastric Malt Lymphoma ◽  
H Pylori

Primary gastric lymphoma (PGL) represents a rare pathology, which can be easily misdiagnosed because of unspecific symptoms of the digestive tract. Histologically, PGL can vary from indolent marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) to aggressive diffuse large B-cell lymphoma (DLBCL). During the years, clinical trials revealed the important role of Helicobacter pylori (H. pylori) in the pathogenesis of gastric MALT lymphoma. Infection with Helicobacter pylori is an influential promoter of gastric lymphomagenesis initiation. Long-term studies revealed that eradication therapy could regress gastric lymphomas.

Transcriptome hallmarks in Helicobacter pylori infection influence gastric cancer and MALT lymphoma

Epigenomics ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 661-671 ◽  
Author(s):  
Jian Zhang ◽  
Jiamin Wei ◽  
Zhixiong Wang ◽  
Yun Feng ◽  
Zhewei Wei ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Noncoding Rna ◽  
Gene Expression Omnibus ◽  
Gastric Malt Lymphoma ◽  
Independent Gene ◽  
Study Results ◽  
H Pylori

Aim: Altered long noncoding RNA (lncRNA) and mRNA is vital in the progression from Helicobacter pylori (H. pylori, HP) infection to gastric cancer (GC) and mucosa-associated lymphoid tissue (MALT) lymphoma. Materials & methods: Five independent Gene Expression Omnibus datasets (GSE5081, GSE84433, GSE15459, GSE66229 and GSE25638) were included in our study. Results: Differentially expressed lncRNAs and mRNAs in both H. pylori-positive gastritis and GC tissues were identified. Using two GC cohorts, the H. pylori-related mRNA DYNC1I1 and MMP7 were independent predictors of overall survival. Moreover, the expressions of lncRNA GHRLOS and 44 mRNAs were significantly changed in gastric MALT lymphoma patients. Conclusion: The lncRNA/mRNA response to H. pylori infection in gastritis and GC influence the outcome of GC and progression of MALT lymphoma.

scholarly journals Gastric mucosa-associated lymphoid tissue lymphoma in conjunction with multiple lymphomatous polyposis in the context of Helicobacter pylori and Helicobacter suis superinfection

2021 ◽  
Author(s):  
Toshikatsu Naito ◽  
Ryo Yuge ◽  
Shinji Tanaka ◽  
Rina Otani ◽  
Hiroki Kadota ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Histopathological Examination ◽  
Endoscopic Examination ◽  
Gastric Body ◽  
Gastric Malt Lymphoma ◽  
Polymerase Chain ◽  
Multiple Lymphomatous Polyposis ◽  
H Pylori

AbstractA 53-year-old woman visited a doctor and complained of chest discomfort after meals. Esophagogastroduodenoscopy showed multiple granular elevations in the gastric body. After biopsies from the elevations, she was diagnosed with mucosa-associated lymphoid tissue (MALT) lymphoma. Polymerase chain reaction also detected Helicobacter pylori and H. suis. Treatment to eradicate H. pylori and H. suis was successful. Endoscopic examination after the bacterial eradication treatment showed that multiple granular elevations remained in the gastric body; however, no lymphoma cells were found during histopathological examination. Thus, we reported a case of H. pylori-positive gastric MALT lymphoma with a unique morphology associated with H. suis superinfection.

Low-grade gastric mucosa-associated lymphoid tissue lymphoma: Clinicopathological factors associated with Helicobacter pylori eradication and tumor regression.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 353-353
Author(s):  
Hyun Ik Shim ◽  
Dong Ho Lee ◽  
Jae Ho Cho ◽  
Cheol Min Shin ◽  
Hyuk Yoon ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Gastric Mucosa ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Tumor Regression ◽  
Neutrophil Infiltration ◽  
Tumor Location ◽  
Gastric Malt Lymphoma ◽  
Low Grade ◽  
H Pylori

353 Background: Eradication of Helicobacter pylori is widely accepted as the initial therapy for low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma. The aim of this study was to assess the remission and relapse rates of low-grade gastric MALT lymphoma after H. pylori eradication and to identify the clinical factors affecting remission. Methods: We retrospectively analyzed 151 patients diagnosed with gastric MALT lymphoma from May 2003 to December 2018. Results: Of the 151 patients, 112 (74.2%) had an H. pylori infection. Total regression rates with eradication was 90.2% (101/112) in H. pylori-positive patients and 55% (11/20) in H. pylori-negative patients. Age, sex, tumor location, endoscopic findings, and the severity of mononuclear lymphocytes were not related to achieving successful initial H. pylori eradication and remission. However, patients with a smaller H. pylori burden ( p=0.030) and less neutrophil infiltration ( p=0.003) were more likely to achieve a successful initial H. pylori eradication. H. pylori ( p<0.001) and the burden ( p=0.020) were significantly related to remission of MALT lymphoma. Conclusions: The results show that H. pylori burden and neutrophil infiltration were inversely related to the success of the initial H. pylori eradication procedure and that the H. pylori burden was inversely related to the remission of MALT lymphoma.

scholarly journals HELICOBACTER PYLORI AND t(11;18)(q21;q21) TRANSLOCATION IN GASTRIC MALT LYMPHOMA

2014 ◽  
Vol 51 (2) ◽  
pp. 84-89 ◽  
Author(s):  
Karine Sampaio LIMA ◽  
Walton ALBUQUERQUE ◽  
Vitor Nunes ARANTES ◽  
Ana Paula DRUMMOND-LAGE ◽  
Luiz Gonzaga Vaz COELHO
Keyword(s):  
Helicobacter Pylori ◽  
Malt Lymphoma ◽  
Tumor Regression ◽  
Histopathological Examination ◽  
Gastric Malt Lymphoma ◽  
Consecutive Series ◽  
Low Grade ◽  
Genetic Translocation ◽  
Tumor Involvement ◽  
H Pylori

ContextGastric mucosa-associated lymphoid tissue (MALT) lymphoma is clearly associated with Helicobacter pylori gastritis and can be cured with anti- H pylori therapy alone. The presence of t(11;18)(q21;q21) translocation is thought to predict a lower response rate to anti- H pylori treatment.ObjectivesTo study the presence of t(11;18)(q21;q21) genetic translocation and its clinical impact in low-grade gastric MALT lymphoma Brazilian patients.MethodsA consecutive series of eight patients with gastric MALT lymphoma were submitted to gastroscopy, endoscopic ultrasound, histopathological examination, H pylori search and RT-PCR-based methodology. All patients received anti-H pylori treatment. Eradicated patients were followed-up every 3-6 months for 2 years.ResultsEight patients were studied. All patients had tumor involvement restricted to the mucosa or submucosa and seven patients had low-grade gastric MALT lymphoma. All infected patients achieved H pylori eradication. Histological tumor regression was observed in 5/7 (71%) of the low-grade gastric MALT lymphoma patients. The presence of t(11;18)(q21;q21) translocation was found in 4 (57%) of these patients; among them only two had histological tumor regression following H pylori eradication.ConclusionsRT-PCR is a feasible and efficient method to detect t(11;18)(q21;q21) translocation, being carried out in routine molecular biology laboratories. The early detection of such translocation can be very helpful for better targeting the therapy to be applied to gastric MALT lymphoma patients.

scholarly journals Treatment of low-grade gastric malt lymphoma using Helicobacter pylori eradication

2015 ◽  
Vol 72 (5) ◽  
pp. 431-436 ◽  
Author(s):  
Sasa Grgov ◽  
Vuka Katic ◽  
Miljan Krstic ◽  
Aleksandar Nagorni ◽  
Biljana Radovanovic-Dinic ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Malt Lymphoma ◽  
Cell Lymphoma ◽  
Eradication Therapy ◽  
Large Cell ◽  
Gastric Malt Lymphoma ◽  
Low Grade ◽  
Diffuse Large Cell Lymphoma ◽  
Large Cell Lymphoma ◽  
H Pylori

Background/Aim. Lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) of the stomach usually occurs as a consequence of Helicobacter pylori (H. pylori) infection. The aim of this study was to investigate the long-term effect of treatment of low-grade gastric MALT lymphoma with the H. pylori eradication method. Methods. In the period 2002-2012 in 20 patients with dyspepsia, mean age 55.1 years, the endoscopic and histologic diagnosis of gastric MALT lymphoma in the early stages were made. Histological preparations of endoscopic biopsy specimens were stained with hematoxyllineosin (HE), histochemical and immunohistochemical methods. Results. Endoscopic findings of gastritis were documented in 25% of the patients, and 75% of the patients had hypertrophic folds, severe mucosal hyperemia, fragility, nodularity, exulcerations and rigidity. Histopathologically, pathognomonic diagnostic criterion were infiltration and destruction of glandular epithelium with neoplastic lymphoid cells, the so-called lymphoepithelial lesions. In all 20 patients H. pylori was verified by rapid urease test and Giemsa stain. After the triple eradication therapy complete remission of MALT lymphoma was achieved in 85% of the patients, with no recurrence of lymphoma and H. pylori infection in the average follow-up period of 48 months. In 3 (15%) of the patients, there was no remission of MALT lymphoma 12 months after the eradication therapy. Of these 3 patients 2 had progression of MALT lymphoma to diffuse large-cell lymphoma. Conclusion. Durable complete re-mission of low-grade gastric MALT lymphoma is achieved in a high percentage after eradication of H. pylori infection, thus preventing the formation of diffuse large-cell lymphoma and gastric adenocarcinoma.

scholarly journals Strong BCL10 Nuclear Expression Identifies Gastric MALT Lymphomas That Do Not Respond to H. pylori Eradication.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 982-982
Author(s):  
Hongtao Ye ◽  
Liping Gong ◽  
Hongxiang Liu ◽  
Agnes Ruskone-Fourmestraux ◽  
Daphne de Jong ◽  
...  
Keyword(s):  
Malt Lymphoma ◽  
Chromosome Translocation ◽  
Gastric Malt Lymphoma ◽  
Complete Regression ◽  
Nuclear Staining ◽  
Interphase Fish ◽  
Nuclear Expression ◽  
Reverse Transcription Pcr ◽  
H Pylori ◽  
High Level

Abstract Purpose: In a previous retrospective study, we have shown that 75% of gastric MALT lymphomas that did not respond to H. pylori eradication could be identified by detection of t(11;18)(q21;q21). The present study examined the value of t(1;14)(p22;q32) in prediction of the response of gastric MALT lymphomas to H. pylori eradication. Patients and Methods: A total of 111 patients with H. pylori-positive gastric MALT lymphoma, who were treated by H. pylori eradication, were screened for BCL10 involved chromosome translocation by BCL10 immunohistochemistry, followed by interphase FISH and real-time quantitative reverse transcription PCR (qRT-PCR). The clinical presentation of 11 cases of MALT lymphoma including 6 from the stomach with known BCL10 involved chromosome translocation was reviewed. Results: Of the 111 cases of gastric MALT lymphoma treated by H. pylori eradication, 75 including 35 from the complete regression group and 40 from the non-responsive group, had adequate specimens for BCL10 immunohistochemistry. Two cases showed strong BCL10 nuclear staining in virtually all tumor cells, similar to that seen in those with t(1;14)(p22;q32). Both were from the H. pylori eradication non-responsive group. Although interphase FISH failed to show evidence of BCL10 gene break or amplification, one case showed an IGH break. This case also showed a high level of BCL10 mRNA expression, compatible to that seen in MALT lymphoma with t(1;14)(p22;q32). 9 of the 11 cases with known BCL10 involved translocation were at stage IIE or above, with three showing agressive clinical presentations. Conclusion: Gastric MALT lymphomas with strong BCL10 nuclear expression or t(1;14)(p22;q32) are mostly likely resistant to H. pylori eradication.

scholarly journals The Helicobacter pylori CagY Protein Drives Gastric Th1 and Th17 Inflammation and B Cell Proliferation in Gastric MALT Lymphoma

2021 ◽  
Vol 22 (17) ◽  
pp. 9459
Author(s):  
Chiara Della Bella ◽  
Maria Felicia Soluri ◽  
Simone Puccio ◽  
Marisa Benagiano ◽  
Alessia Grassi ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Helicobacter Pylori ◽  
T Cell ◽  
B Cell ◽  
Malt Lymphoma ◽  
Chronic Gastritis ◽  
Gastric Malt Lymphoma ◽  
Low Grade ◽  
Cell Clones ◽  
H Pylori

Background: the neoplastic B cells of the Helicobacter pylori-related low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma proliferate in response to H. pylori, however, the nature of the H. pylori antigen responsible for proliferation is still unknown. The purpose of the study was to dissect whether CagY might be the H. pylori antigen able to drive B cell proliferation. Methods: the B cells and the clonal progeny of T cells from the gastric mucosa of five patients with MALT lymphoma were compared with those of T cell clones obtained from five H. pylori–infected patients with chronic gastritis. The T cell clones were assessed for their specificity to H. pylori CagY, cytokine profile and helper function for B cell proliferation. Results: 22 of 158 CD4+ (13.9%) gastric clones from MALT lymphoma and three of 179 CD4+ (1.7%) clones from chronic gastritis recognized CagY. CagY predominantly drives Interferon-gamma (IFN-γ) and Interleukin-17 (IL-17) secretion by gastric CD4+ T cells from H. pylori-infected patients with low-grade gastric MALT lymphoma. All MALT lymphoma-derived clones dose dependently increased their B cell help, whereas clones from chronic gastritis lost helper activity at T-to-B-cell ratios greater than 1. Conclusion: the results obtained indicate that CagY drives both B cell proliferation and T cell activation in gastric MALT lymphomas.

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