scholarly journals Early, Isolated Duodenal Mucosa-Associated Lymphoid Tissue Lymphoma Presenting without Symptoms or Grossly Apparent Endoscopic Lesions and Diagnosed by Random Duodenal Biopsies

2016 ◽  
Vol 10 (2) ◽  
pp. 323-331 ◽  
Author(s):  
Mihajlo Gjeorgjievski ◽  
Issa Makki ◽  
Pradeep Khanal ◽  
Mitual B. Amin ◽  
Ann Marie Blenc ◽  
...  
Keyword(s):  
Lymphoid Tissue ◽  
Duodenal Mucosa ◽  
Clinical Feature ◽  
Helicobactor Pylori ◽  
Duodenal Lesions ◽  
Relative Rarity ◽  
Pathologic Analysis ◽  
H Pylori ◽  
Involuntary Weight Loss ◽  
Duodenal Biopsies

Clinical data regarding mucosa-associated lymphoid tissue lymphoma (MALToma) solely involving the duodenum are sparse because of the relative rarity of the disease. A comprehensive literature review revealed only 17 cases reported until 2004, and only a moderate number of cases have been reported since. MALToma can be asymptomatic in its very early stages but frequently produces localized or nonspecific symptoms, including early satiety, abdominal pain, vomiting, and involuntary weight loss in later stages. While gastric MALToma is strongly associated with gastric Helicobactor pylori infection, duodenal MALToma is often unassociated with H. pylori infection. A 74-year-old female presented with only dysphagia (without symptoms referable to a duodenal lesion), without systemic ‘B’ symptoms, and with no evident duodenal lesions at esophagogastroduodenoscopy; however, she was diagnosed with duodenal MALToma by pathologic examination of random duodenal biopsies performed to exclude celiac disease. An important clinical feature of this case is that duodenal MALToma was diagnosed by pathologic analysis of duodenal biopsies despite (1) no endoscopically apparent duodenal lesions; (2) duodenal involvement without gastric involvement; (3) lack of symptoms attributable to duodenal MALToma, and (4) absence of evident H. pylori infection. This work shows that early duodenal MALToma can be difficult to diagnose because of absent symptoms, absence of gastric involvement, absence of endoscopic abnormalities, and absence of H. pylori infection; it may require random duodenal biopsies for diagnosis.

scholarly journals A case of gastric and duodenal mucosa-associated lymphoid tissue lymphoma with multiple gastric cancers: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takashi Yokoyama ◽  
Tetsuya Tanaka ◽  
Suzuka Harada ◽  
Takeshi Ueda ◽  
Goki Ejiri ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Regional Lymph Node ◽  
Duodenal Bulb ◽  
Duodenal Mucosa ◽  
Upper Endoscopy ◽  
Gastric Cancers ◽  
Regional Lymph Node Dissection ◽  
H Pylori

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.

scholarly journals Duodenal Mucosa-associated Lymphoid Tissue Lymphoma Treated with Chemotherapy

2020 ◽  
Vol 20 (1) ◽  
pp. 63-67
Author(s):  
Jee young An ◽  
Joon Sung Kim ◽  
Byung Wook Kim
Keyword(s):  
Duodenal Ulcer ◽  
Helicobacter Pylori ◽  
Complete Remission ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Duodenal Mucosa ◽  
Gastric Malt Lymphoma ◽  
Treatment Methods ◽  
H Pylori

Mucosa-associated lymphoid tissue (MALT) lymphomas most commonly occur in the stomach and rarely in the duodenum. Gastric MALT lymphoma is usually associated with <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection that may be cured by eradication. However, duodenal MALT lymphoma is not associated with <i>H. pylori</i> infection. Moreover, the pathophysiology and treatment methods for duodenal MALT lymphoma have not yet been established because the disease is rare. Here, we report a case of duodenal MALT lymphoma. A 58-year-old man was treated for a refractory duodenal ulcer. Based on repeated biopsy, a diagnosis of MALT lymphoma was made. The patient achieved complete remission after chemotherapy and was followed up without recurrence for three years.

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

Cancers ◽  
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.

Histopathology of Gastric and Duodenal Strongyloides stercoralis Locations in Fifteen Immunocompromised Subjects

2006 ◽  
Vol 130 (12) ◽  
pp. 1792-1798 ◽  
Author(s):  
Francesco Rivasi ◽  
Silvio Pampiglione ◽  
Renzo Boldorini ◽  
Loredana Cardinale
Keyword(s):  
Colorectal Adenocarcinoma ◽  
Parasitic Infection ◽  
Strongyloides Stercoralis ◽  
Duodenal Mucosa ◽  
Gastric Ulcers ◽  
Immunocompromised Patients ◽  
Histologic Diagnosis ◽  
Immunodeficiency Virus ◽  
Gastric Biopsies ◽  
Duodenal Biopsies

Abstract Context.—Strongyloidiasis is a worldwide parasitic infection affecting approximately 75 million people. In Italy, it was more prevalent in the past among rural populations of irrigated areas. Objective.—To determine the histopathologic alterations of the gastric and duodenal mucosa associated with the presence of Strongyloides stercoralis parasites. Design.—Fifteen cases of strongyloidiasis were observed in immunocompromised patients during a recent 6-year period in Italy. S stercoralis was found histologically in gastric biopsies (10 cases), in a gastrectomy (1 case), and in duodenal biopsies (9 cases). In 5 cases the parasite was present both in gastric and duodenal biopsies. Four patients were affected by lymphoma, 2 by multiple myeloma, 2 by gastric carcinoma, 1 by chronic myeloid leukemia, 1 by sideroblastic anemia, 1 by colorectal adenocarcinoma, 1 by chronic idiopathic myelofibrosis, 1 by chronic gastritis, 1 by gastric ulcers, and 1 by rheumatoid arthritis in corticosteroid therapy. No patient was affected by human immunodeficiency virus infection. Strongyloidiasis was not clinically diagnosed. Results.—Histologic examination revealed several sections of S stercoralis larvae, many eggs, and some adult forms. All the parasites were located in the gastric and/or the duodenal crypts. Eosinophils infiltrating into the lamina propria were found in all cases; their intensity was correlated with the intensity of the infection. Conclusions.—Histologic diagnosis of strongyloidiasis must be taken into consideration when examining both gastric and duodenal biopsies in immunocompromised patients, to avoid the development of an overwhelming infection of the parasite, which is dangerous for the life of the patient.

scholarly journals Descriptive Study of the Different Tools Used to Evaluate the Adherence to a Gluten-Free Diet in Celiac Disease Patients

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1777 ◽  
Author(s):  
Luis Rodrigo ◽  
Isabel Pérez-Martinez ◽  
Eugenia Lauret-Braña ◽  
Adolfo Suárez-González
Keyword(s):  
Celiac Disease ◽  
Multidisciplinary Approach ◽  
Descriptive Study ◽  
Duodenal Mucosa ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Autoimmune Process ◽  
Duodenal Biopsies

Celiac disease (CD) is a genetically conditioned autoimmune process that appears in susceptible people. It can affect people of any age, and slightly predominates in females. It has a fairly homogenous global distribution, with an average prevalence of 1–2%, the frequency having increased in recent decades. The only effective treatment is a strict and permanent gluten-free diet (GFD), although the level of compliance is poor, at about 50% of cases. To monitor the effectiveness of the GFD, several procedures involving various approaches are employed: (a) Periodic visits by expert Nutritionists; (b) Clinical follow-up; (c) Serological time controls of specific antibodies; (d) Serial endoscopies with collection of duodenal biopsies; (e) Use of structured questionnaires; and (f) Determination of gluten peptides derived from gluten in faeces and/or urine. All of these procedures are useful when applied, alone or in combination, depending on the cases. Some patients will only need to consult to their doctors, while others will require a multidisciplinary approach to assess their compliance with the GFD. In children, normalization of duodenal mucosa was achieved in 95% of cases within two years, while it is more delayed in adults, whose mucosa take longer time (3–5 years) to heal completely.

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

Blood ◽  
2001 ◽  
Vol 98 (4) ◽  
pp. 1182-1187 ◽  
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.

scholarly journals Role of Crush Cytology for the Detection of Helicobacter Pylori in Gastroduodenal Diseases

1970 ◽  
Vol 17 (2) ◽  
pp. 88-93
Author(s):  
K Ahsan ◽  
MZ Hossain ◽  
MR Uddin
Keyword(s):  
Helicobacter Pylori ◽  
Histopathological Examination ◽  
Cross Sectional Study ◽  
Biopsy Material ◽  
Cross Sectional ◽  
Gastroduodenal Disease ◽  
Duodenal Lesions ◽  
Bismuth Salts ◽  
H Pylori ◽  
Low Sensitivity

Context: A cross-sectional study was carried out at the Department of Pathology, Dhaka Medical Collage, Dhaka and Immunology Laboratory, Laboratory Sciences Division of ICDDR,B, Dhaka during a period of 1 year from July, 2007 to June, 2008 to determine the efficacy of endoscopic crush cytology in the detection of Helicobacter pylori infection in gastroduodenal diseases. Clinically suspected cases of gastro-duodenal lesions and who had not taken antibiotics, omeprazole or bismuth salts for at least three weeks prior to endoscopy were selected. Patients who were clinically and endoscopically suspected of having malignancy were excluded from the study. A total of 110 such subjects were consecutively included in the study. The statistics used to analyze the data were descriptive statistics and components of accuracy test.Results: The sensitivity of crush cytology in correctly diagnosing H. pylori of those who had the disease was 89.3%, while the specificity of the test in correctly differentiating those who did not have H. pylori was 92.6% when compared against histopathological examination using Giemsa stain. However, a slightly low sensitivity (86.2%) without compromising with specificity (92.3%) was obtained when the crush cytology diagnosis was compared against histopathological examination using haematoxylin-eosin (H & E) stain.Conclusion: The study concludes that the diagnostic accuracy of crush smear cytology (sensitivity and specificity) for detection of Helicobacter pylori in gastric biopsy material is comparable to histopathology. Moreover, the technique is very simple, less expensive and less time consuming which gives clinicians added advantage in making a quicker decision.Key words: Cytology; Helicobacter pylori; Gastroduodenal disease. DOI: 10.3329/jdmc.v17i2.6589J Dhaka Med Coll. 2008; 17(2) : 88-93

scholarly journals Histopathological Spectrum of Upper Gastrointestinal Endoscopic Biopsies in a Tertiary care centre

2021 ◽  
Vol 8 (6) ◽  
pp. A158-163
Author(s):  
Anjana M.L ◽  
Kavitha Yevoor
Keyword(s):  
Tertiary Care ◽  
Common Symptom ◽  
Female Ratio ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Wide Range ◽  
Neoplastic Lesions ◽  
Upper Gi Endoscopy ◽  
H Pylori ◽  
Duodenal Biopsies

Background: Upper GI endoscopy is an established procedure for investigating a wide range of upper GI conditions especially inflammatory and malignant diseases of stomach and esophagus. A good correlation in diagnosis can be achieved by complementing endoscopic findings with histopathology of biopsy specimens. Methods: Both retrospective and prospective study of upper GI endoscopic biopsy was carried out at department of pathology, KIMS, Hubli during January 2016 to December 2018. Samples were received in 10% formalin; routine processing was followed with H & E staining. Special stain like Giemsa was done for detection of H. Pylori. 396 endoscopic mucosal biopsies were analyzed and evaluated. Result: Out of 396 cases, 250 cases were esophageal biopsies, 104 cases were gastric biopsies & 42 cases were duodenal biopsies. The male: female ratio was 1:9:1. The highest number of cases was seen between 61 to 70 years. Dyspepsia was the common symptom seen in 61.3%. The most common lesions encountered in the esophagus were carcinomas (67%) followed by esophagitis (16%). The commonly encountered gastric lesion was chronic gastritis in 54.8% with H. pylori gastritis being positive in 38.18%. Among the duodenal biopsies, non-neoplastic lesions were most common (59.5%) followed by neoplastic lesions (26%). Conclusion: Upper GI endoscopy is an effective and appropriate preliminary investigation to assess patients with dysphagia, dyspepsia, vomiting. Endoscopy without biopsy is incomplete and that the combination of methods offers a strong diagnostic tool for better patient care.

Relationship between gastric localization of HCV and gastric, H. pylori-related lymphoid tissue

2001 ◽  
Vol 34 ◽  
pp. 130
Author(s):  
G. Cammarota ◽  
R. Cianci ◽  
L.M. Larocca ◽  
F. Pandolfi ◽  
A. Gasbarrini ◽  
...  
Keyword(s):  
Lymphoid Tissue ◽  
H Pylori

Helicobacter pylori colonisation of duodenal foveolar metaplasia requires concurrent gastric infection

2020 ◽  
pp. jclinpath-2020-206844
Author(s):  
Adam L Booth ◽  
Raul S Gonzalez
Keyword(s):  
Helicobacter Pylori ◽  
Chronic Gastritis ◽  
Immunohistochemical Staining ◽  
Acute Inflammation ◽  
Common Symptom ◽  
Routine Examination ◽  
Histological Changes ◽  
Normal Limits ◽  
H Pylori ◽  
Duodenal Biopsies

AimsEvaluate the rate and significance of Helicobacter pylori (H. pylori) involving duodenal foveolar metaplasia of chronic peptic duodenitis (CPD).MethodsWe identified 100 biopsy cases of CPD with synchronous stomach biopsies. All 200 were reviewed for histological changes (eg, chronic gastritis, acute inflammation) and underwent immunohistochemical staining for H. pylori. Results were correlated with patient age, sex, endoscopy indication and findings on stomach biopsy.ResultsCases included 49 men and 51 women, with a median age of 56 years. Reflux or dysphagia was the most common symptom. Chronic gastritis was present in 46 stomach biopsies, with 54 within normal limits. Twelve stomach biopsies showed H. pylori, all of which showed gastritis. Two duodenal biopsies (2%) demonstrated H. pylori organisms on immunohistochemistry, both from patients with H. pylori gastritis.ConclusionsRoutine examination of CPD samples for H. pylori appears unnecessary if a stomach biopsy is available for review.

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