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.

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 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.

scholarly journals Helicobacter pylori cagA status and gastric mucosa-associated lymphoid tissue lymphoma: a systematic review and meta-analysis

2022 ◽  
Vol 41 (1) ◽  
Author(s):  
Masoud Keikha ◽  
Amirhossein Sahebkar ◽  
Yoshio Yamaoka ◽  
Mohsen Karbalaei
Keyword(s):  
B Cell ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Cell Lymphoma ◽  
Meta Analysis ◽  
B Cell Lymphoma ◽  
Gastric Malt Lymphoma ◽  
Large B Cell Lymphoma ◽  
H Pylori

Abstract Background Recent studies have investigated the role of Helicobacter pylori infection in the development of gastric mucosa-associated lymphoid tissue (MALT) lymphoma. It is estimated that approximately 0.1% of people infected with H. pylori develop gastric MALT lymphoma. However, the role of the CagA antigen, the highest causative agent of H. pylori, in increasing the risk of gastric MALT lymphoma remains unclear and controversial. A systematic review and meta-analysis were conducted to evaluate the effect of cagA status on the development of gastric MALT lymphoma. Methods All articles evaluating the status of the cagA gene in the development of gastric MALT lymphoma were collected using systematic searches in online databases, including PubMed, Scopus, Embase, and Google Scholar, regardless of publication date. The association between cagA and gastric MALT lymphoma was assessed using the odds ratio (OR) summary. In addition, a random-effects model was used in cases with significant heterogeneity. Results A total of 10 studies met our inclusion criteria, among which 1860 patients participated. No association between cagA status and the development of MALT lymphoma (extranodal marginal zone B-cell lymphoma) was found in this study (OR 1.30; 0.906–1.866 with 95% CIs; I2: 45.83; Q-value: 12.92). Surprisingly, a meaningful association was observed between cagA status and diffuse large B-cell lymphoma (OR 6.43; 2.45–16.84 with 95% CIs). We also observed an inverse association between vacA and gastric MALT lymphoma risk (OR 0.92; 0.57–1.50 with 95% CIs). Conclusions It seems that the infection with cagA-positive H. pylori strains does not have a meaningful effect on the gastric MALT lymphoma formation, while translocated CagA antigen into the B cells plays a crucial role in the development of diffuse large B-cell lymphoma.

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 Novel Insights of Lymphomagenesis of Helicobacter pylori-Dependent Gastric Mucosa-Associated Lymphoid Tissue Lymphoma

Cancers ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 547 ◽  
Author(s):  
Sung-Hsin Kuo ◽  
Ming-Shiang Wu ◽  
Kun-Huei Yeh ◽  
Chung-Wu Lin ◽  
Ping-Ning Hsu ◽  
...  
Keyword(s):  
T Cells ◽  
Helicobacter Pylori ◽  
B Cells ◽  
Gastric Mucosa ◽  
B Cell ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
B Cell Lymphoma ◽  
Gastric Malt Lymphoma ◽  
First Line

Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is the most common subtype of gastric lymphoma. Most gastric MALT lymphomas are characterized by their association with the Helicobacter pylori (HP) infection and are cured by first-line HP eradication therapy (HPE). Several studies have been conducted to investigate why most gastric MALT lymphomas remain localized, are dependent on HP infection, and show HP-specific intratumoral T-cells (e.g., CD40-mediated signaling, T-helper-2 (Th2)-type cytokines, chemokines, costimulatory molecules, and FOXP3+ regulatory T-cells) and their communication with B-cells. Furthermore, the reason why the antigen stimuli of these intratumoral T-cells with tonic B-cell receptor signaling promote lymphomagenesis of gastric MALT lymphoma has also been investigated. In addition to the aforementioned mechanisms, it has been demonstrated that the translocated HP cytotoxin-associated gene A (CagA) can promote B-cell proliferation through the activation of Src homology-2 domain-containing phosphatase (SHP-2) phosphorylation-dependent signaling, extracellular-signal-regulated kinase (ERK), p38 mitogen-activated protein kinase (MAPK), B-cell lymphoma (Bcl)-2, and Bcl-xL. Furthermore, the expression of CagA and these CagA-signaling molecules is closely associated with the HP-dependence of gastric MALT lymphomas (completely respond to first-line HPE). In this article, we summarize evidence of the classical theory of HP-reactive T-cells and the new paradigm of direct interaction between HP and B-cells that contributes to the HP-dependent lymphomagenesis of gastric MALT lymphomas. Although the role of first-line HPE in the treatment of HP-negative gastric MALT lymphoma remains uncertain, several case series suggest that a proportion of HP-negative gastric MALT lymphomas remains antibiotic-responsive and is cured by HPE. Considering the complicated interaction between microbiomes and the genome/epigenome, further studies on the precise mechanisms of HP- and other bacteria-directed lymphomagenesis in antibiotic-responsive gastric MALT lymphomas are warranted.

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.

Nuclear Expression of BCL10 or Nuclear Factor Kappa B Predicts Helicobacter pylori–Independent Status of Early-Stage, High-Grade Gastric Mucosa-Associated Lymphoid Tissue Lymphomas

2004 ◽  
Vol 22 (17) ◽  
pp. 3491-3497 ◽  
Author(s):  
Sung-Hsin Kuo ◽  
Li-Tzong Chen ◽  
Kun-Huei Yeh ◽  
Ming-Shiang Wu ◽  
Hui-Chen Hsu ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Gastric Mucosa ◽  
Lymphoid Tissue ◽  
Nuclear Factor Kappa B ◽  
Early Stage ◽  
Gastric Malt Lymphoma ◽  
Nuclear Factor ◽  
High Grade ◽  
Nuclear Expression ◽  
H Pylori

Purpose A high percentage of early-stage, high-grade gastric mucosa-associated lymphoid tissue (MALT) lymphomas remain Helicobacter pylori dependent. t(11;18)(q21;q21), a genetic aberration highly predictive of H pylori–independent status in low-grade gastric MALT lymphoma, is rarely detected in its high-grade counterpart. This study examined whether nuclear expression of BCL10 or nuclear factor kappa B (NF-κB) is useful in predicting H pylori–independent status in patients with stage IE high-grade gastric MALT lymphomas. Patients and Methods Twenty-two patients who had participated in a prospective study of H pylori eradication for stage IE high-grade gastric MALT lymphomas were studied. The expression of BCL10 and NF-κB in pretreatment paraffin-embedded lymphoma tissues was evaluated by immunohistochemistry and confocal immunofluorescence microscopy. The presence of t(11;18)(q21;q21) was identified by a multiplex reverse transcriptase polymerase chain reaction of the API2-MALT1 chimeric transcript. Results Aberrant nuclear expression of BCL10 was detected in seven (87.5%) of eight H pylori–independent and in none of 14 H pylori–dependent high-grade gastric MALT lymphomas (P < .001). All seven patients with nuclear BCL10 expression had nuclear expression of NF-κB, compared with only two of 15 patients without nuclear BCL10 expression (P = .002). As a single variable, the frequency of nuclear expression of NF-κB was also significantly higher in H pylori–independent tumors than in H pylori–dependent tumors (seven of eight [87.5%] v two of 15 [12.3%]; P = .002). The API2-MALT1 fusion transcript was detected in only one (12.5%) of eight H pylori–independent lymphomas. Conclusion Nuclear expression of BCL10 or NF-κB is highly predictive of H pylori–independent status in high-grade gastric MALT lymphoma, and coexpression of these two markers in the nuclei is frequent.

scholarly journals Evaluation of the Association of Nine Helicobacter pylori Virulence Factors with Strains Involved in Low-Grade Gastric Mucosa-Associated Lymphoid Tissue Lymphoma

2004 ◽  
Vol 72 (2) ◽  
pp. 880-888 ◽  
Author(s):  
Philippe Lehours ◽  
Armelle Ménard ◽  
Sandrine Dupouy ◽  
Bernard Bergey ◽  
Fréderique Richy ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Gastric Mucosa ◽  
Virulence Factors ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Gastric Lymphoma ◽  
Gastric Malt Lymphoma ◽  
Low Grade ◽  
H Pylori ◽  
Few Data

ABSTRACT Helicobacter pylori has been associated with the development of two malignant diseases: gastric adenocarcinoma and gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Although the cag pathogenicity island, especially the cagA gene, has been linked with adenocarcinoma, few data concerning H. pylori pathogenic factors involved in low-grade gastric MALT lymphoma are available. The goal of this study was to analyze the prevalence of and correlation between genes coding for seven H. pylori virulence factors (cagA, cagE, vacA, iceA, babA, hopQ, and oipA) and two novel adhesins (sabA and hopZ) by comparing a collection of 43 H. pylori strains isolated from patients with low-grade gastric MALT lymphoma to 39 strains isolated from age-matched patients with gastritis only. Our results show that taken individually, none of the nine genes tested can be considered associated with MALT strains and allow us to conclude that MALT pathogenesis is not linked with more proinflammatory H. pylori strains. We demonstrated that in patients infected with strains harboring the iceA1 allele, sabA functional status, and hopZ “off” status, the odds of developing a MALT lymphoma were 10 times higher. However, the low prevalence of such strains (10 of 43 MALT strains) renders this triple association a low-sensitivity marker for MALT strains. Our data confirmed that H. pylori virulence factors are correlated with one another. If the involvement of H. pylori in MALT lymphoma is well established, the pathomechanism by which gastric lymphoma occurs remains to be identified.

Sign in / Sign up

Export Citation Format

Share Document