Prognostic significance of serum immunoglobulin paraprotein in mucosa‐associated lymphoid tissue (MALT) lymphoma

Abstract Background Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is often caused by Helicobacter pylori and has a good prognosis. Rarely, patients with MALT lymphoma may have gastric cancer and have a poor prognosis. Case presentation We herein report a case in which surgical treatment was achieved for a 72-year-old male patient with gastric and duodenal MALT lymphoma coexisting multiple gastric cancers. He underwent upper endoscopy for epigastric discomfort, which revealed mucosal erosion on the posterior wall of the middle body of the stomach, an elevated lesion on the duodenal bulb, and a raised tumor on the antrum of the stomach. He was diagnosed with gastric and duodenal MALT lymphoma with early gastric cancer. One month after H. pylori eradication, a second upper endoscopy revealed no improvement in the gastric or duodenal mucosa, and areas of strong redness with a shallow recess just below the cardia of the stomach. As a result, a diagnosis of gastric and duodenal MALT lymphoma with two gastric cancers was made. Total gastrectomy with proximal duodenum resection using intraoperative upper endoscopy and regional lymph node dissection was performed. Pathologically, gastric and duodenal MALT lymphoma and three gastric cancers were detected. Since one of them was an advanced cancer, he started taking S-1 after his general condition improved. Conclusion For early detection of gastric and duodenal MALT lymphoma or gastric cancer, appropriate upper endoscopy and a biopsy are important. It is necessary to select a suitable treatment, such as H. pylori eradication, endoscopic treatment, surgery, chemotherapy, and irradiation, according to the disease state.

Download Full-text

Genetic Characterization and Clinical Features of Helicobacter pylori Negative Gastric Mucosa-Associated Lymphoid Tissue Lymphoma

Cancers ◽

10.3390/cancers13122993 ◽

2021 ◽

Vol 13 (12) ◽

pp. 2993

Author(s):

Barbara Kiesewetter ◽

Christiane Copie-Bergman ◽

Michael Levy ◽

Fangtian Wu ◽

Jehan Dupuis ◽

...

Keyword(s):

Gastric Mucosa ◽

Signaling Pathways ◽

Clinical Features ◽

Malt Lymphoma ◽

Lymphoid Tissue ◽

Targeted Sequencing ◽

Clinicopathological Parameters ◽

Gastric Malt Lymphoma ◽

Genetic Changes ◽

H Pylori

Background: In Western countries, the prevalence of gastric mucosa-associated lymphoid tissue (MALT) lymphoma has declined over the last three decades. Contemporaneously, H. pylori negative gastric MALT lymphoma is increasingly encountered, and their genetic basis and clinical features remain elusive. Methods: A total of 57 cases of H. pylori negative gastric MALT lymphoma were reviewed and investigated for chromosome translocation by fluorescence in-situ hybridization and for somatic mutations by the targeted sequencing of 93 genes. Results: MALT1 translocation, most likely t(11;18)(q21;q21)/BIRC3-MALT1, was detected in 39% (22/57) cases, and IGH translocation was further seen in 12 MALT1-negative cases, together accounting for 60% of the cohort. Targeted sequencing was successful in 35 cases, and showed frequent mutations in NF-κB signaling pathways (TNFAIP3 = 23%, CARD11 = 9%, MAP3K14 = 9%), together affecting 14 cases (40%). The NF-κB pathway mutations were mutually exclusive from MALT1, albeit not IGH translocation, altogether occurring in 86% of cases. There was no significant correlation between the genetic changes and clinicopathological parameters. The patients showed a median of progression-free survival (PFS) of 66.3 months, and a significant superior PFS when treated with systemic versus antibiotic therapy (p = 0.004). Conclusion: H. pylori negative gastric MALT lymphoma is characterized by highly frequent genetic changes in the NF-κB signaling pathways.

Download Full-text

Mucosa-associated lymphoid tissue (MALT) lymphoma developing in ectopic mediastinal thyroid tissue: a case report

Surgical Case Reports ◽

10.1186/s40792-020-00857-2 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Naotaka Uchida ◽

Manabu Yoshida

Keyword(s):

Case Report ◽

Malt Lymphoma ◽

Lymphoid Tissue ◽

Thyroid Tissue

Download Full-text

Comparison of Localized Gastric Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma with and without Helicobacter pylori Infection

Helicobacter ◽

10.1111/j.1523-5378.2006.00382.x ◽

2006 ◽

Vol 11 (2) ◽

pp. 86-95 ◽

Cited By ~ 42

Author(s):

Taiji Akamatsu ◽

Taro Mochizuki ◽

Yoko Okiyama ◽

Akihiro Matsumoto ◽

Hideharu Miyabayashi ◽

...

Keyword(s):

Helicobacter Pylori ◽

Gastric Mucosa ◽

Malt Lymphoma ◽

Lymphoid Tissue ◽

Helicobacter Pylori Infection

Download Full-text

A phase II study of lenalidomide in patients with extranodal marginal zone B-cell lymphoma of the mucosa associated lymphoid tissue (MALT lymphoma)

Haematologica ◽

10.3324/haematol.2012.065995 ◽

2012 ◽

Vol 98 (3) ◽

pp. 353-356 ◽

Cited By ~ 55

Author(s):

B. Kiesewetter ◽

M. Troch ◽

W. Dolak ◽

L. Mullauer ◽

J. Lukas ◽

...

Keyword(s):

B Cell ◽

Phase Ii ◽

Malt Lymphoma ◽

Lymphoid Tissue ◽

Marginal Zone ◽

Phase Ii Study ◽

Cell Lymphoma ◽

B Cell Lymphoma

Download Full-text

18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Findings in Mucosa-Associated Lymphoid Tissue Lymphoma of the Larynx: A Case Report and Literature Review

Journal of International Medical Research ◽

10.1177/147323001204000340 ◽

2012 ◽

Vol 40 (3) ◽

pp. 1192-1206 ◽

Cited By ~ 9

Author(s):

K Zhao ◽

Y-Z Luo ◽

S-H Zhou ◽

B-L Dai ◽

X-M Luo ◽

...

Keyword(s):

Computed Tomography ◽

Positron Emission Tomography ◽

Malt Lymphoma ◽

Lymphoid Tissue ◽

Immunohistochemical Analysis ◽

Emission Tomography ◽

Positron Emission ◽

Laryngeal Mucosa ◽

Pet Ct ◽

Fdg Pet Ct

Laryngeal mucosa-associated lymphoid tissue (MALT) lymphoma is rare, with only 25 cases reported in the literature. This report presents a case of laryngeal MALT lymphoma in a 35-year-old female with a 6-year history of progressively worsening hoarseness. MALT lymphoma was diagnosed based on biopsy and immunohistochemical analysis. The patient received two cycles of cyclo-phosphamide + epirubicin + vincristine + prednisone (CHOP) chemo therapy, which was ineffective. 18F-fluoro deoxy glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) showed 18F-FDG accumulation in the larynx only and identified stage IE lymphoma. CHOP chemotherapy was terminated and the patient was treated with radiotherapy. After 3 months (total radiation dose 27 Gy), 18F-FDG PET/CT scan showed that the laryngeal lesion was in complete remission. A review of the literature on the MEDLINE®/PubMed® databases regarding laryngeal MALT lymphoma and the use of PET/CT found that radiotherapy is the firstline treatment for stage I and II MALT lymphoma.

Download Full-text

T(11;18)(q21;q21) is associated with advanced mucosa-associated lymphoid tissue lymphoma that expresses nuclear BCL10

Blood ◽

10.1182/blood.v98.4.1182 ◽

2001 ◽

Vol 98 (4) ◽

pp. 1182-1187 ◽

Cited By ~ 172

Author(s):

Hongxiang Liu ◽

Hongtao Ye ◽

Ahmet Dogan ◽

Renzo Ranaldi ◽

Rifat A. Hamoudi ◽

...

Keyword(s):

Malt Lymphoma ◽

Lymphoid Tissue ◽

Fusion Transcript ◽

Low Grade ◽

Chain Reaction ◽

Nuclear Expression ◽

Molecular Events ◽

Multistep Process ◽

Polymerase Chain ◽

H Pylori

The development of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a multistep process and can be clinico-pathologically divided into Helicobacter pylori-associated gastritis, low-grade tumors, and high-grade tumors. The molecular events underlying this progression are largely unknown. However, identification of the genes involved in MALT lymphoma-specific t(11;18)(q21;q21) and t(1;14)(p22;q32) has provided fresh insights into the pathogenesis of this disease. T(11;18)(q21;q21) results in a chimeric transcript between the API2 and theMALT1 genes, whereas t(1;14) (p22;q32) causes aberrant nuclear BCL10 expression. Significantly, nuclear BCL10 expression also occurs frequently in MALT lymphomas without t(1;14)(p22;q32), suggesting an important role for BCL10 in lymphoma development. Thirty-three cases of H pylori gastritis, 72 MALT lymphomas, and 11 mucosal diffuse large B-cell lymphomas (DLBCL) were screened for t(11;18)(q21;q21) by reverse transcription–polymerase chain reaction followed by sequencing. BCL10 expression in lymphoma cases was examined by immunohistochemistry. The API2–MALT1 fusion transcript was not detected in H pylorigastritis and mucosal DLBCL but was found in 25 of 72 (35%) MALT lymphomas of various sites. Nuclear BCL10 expression was seen in 28 of 53 (53%) of MALT lymphomas. Of the gastric cases, the largest group studied, the frequency of both t(11;18)(q21;q21) and nuclear BCL10 expression was significantly higher in tumors that showed dissemination to local lymph nodes or distal sites (14 of 18 = 78% and 14 of 15 = 93%, respectively) than those confined to the stomach (3 of 29 = 10% and 10 of 26 = 38%). Furthermore, t(11;18)(q21;q21) closely correlated with BCL10 nuclear expression. These results indicate that both t(11;18)(q21;q21) and BCL10 nuclear expression are associated with advanced MALT lymphoma and that their oncogenic activities may be related to each other.

Download Full-text