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Early gastric MALT lymphoma.
Tsun-I Cheng1, Mei-Hua Tsou, Meng-Pei Tsai
1Department of Medicine, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan, ROC. ticheng@mail.kfcc.org.tw
Journal of the Chinese Medical Association : JCMA
|June 9, 2004
Summary
Follicular gastritis may indicate a risk for mucosa-associated lymphoid tissue (MALT) lymphoma. Eradication of Helicobacter pylori (H. pylori) led to complete resolution of MALT lymphoma in a rare case of normal-appearing gastric MALT lymphoma.
Area of Science:
- Gastroenterology
- Oncology
- Pathology
Background:
- Mucosa-associated lymphoid tissue (MALT) lymphoma classification includes exophytic and infiltrative types.
- Normal-appearing gastric MALT lymphoma is rare, with only one prior case reported.
- Helicobacter pylori (H. pylori) infection is a known risk factor for gastric MALT lymphoma.
Observation:
- A 49-year-old woman presented with indistinct follicular gastritis and a duodenal ulcer scar during routine esophagogastroduodenoscopy.
- Gastric biopsy revealed chronic gastritis with H. pylori and atypical lymphoid infiltration suggestive of MALT lymphoma.
- Polymerase chain reaction confirmed a clonal B cell lymphoproliferation consistent with MALT lymphoma.
Findings:
- The patient was diagnosed with a rare case of normal-appearing gastric MALT lymphoma.
- Treatment with a standard H. pylori eradication regimen (amoxicillin, clarithromycin, omeprazole) resulted in complete disease resolution.
- Follicular gastritis was identified as a potential high-risk precursor condition for MALT lymphoma.
Implications:
- This case highlights the importance of recognizing follicular gastritis as a potential precursor to MALT lymphoma.
- Effective H. pylori eradication can lead to complete remission of gastric MALT lymphoma.
- Further research is warranted to elucidate the relationship between follicular gastritis and MALT lymphoma development.