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Qureshi A, Patel A, Ajumobi AB. H pylori-Negative MALT-Associated Extranodal Marginal Zone Lymphoma: A Comprehensive Case Report and Literature Review. J Investig Med High Impact Case Rep 2024; 12:23247096241238531. [PMID: 38494775 PMCID: PMC10946082 DOI: 10.1177/23247096241238531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/19/2024] [Accepted: 02/25/2024] [Indexed: 03/19/2024] Open
Abstract
Extranodal marginal zone B-cell lymphoma (ENMZL) of mucosa-associated lymphoid tissue (MALT), a rare subtype of B-cell lymphoma, is typically associated with Helicobacter pylori (H pylori) infection, especially in gastric cases. However, this article presents 2 unique cases of H pylori-negative colonic ENMZL, challenging the conventional understanding of the disease. The first case involves an 80-year-old male diagnosed with Stage 1E ENMZL in the descending colon, and the second describes a 74-year-old male with sigmoid colon ENMZL. Both cases lacked H pylori infection, adding complexity to their management. Accompanying these case studies is a comprehensive literature review, delving into the epidemiology, pathology, clinical features, diagnosis, and treatment of H pylori-negative ENMZL, with a focus on gastrointestinal involvement. This review highlights the importance of considering H pylori-negative cases in ENMZL diagnosis and management, illustrating the need for further research and individualized treatment approaches in this uncommon lymphoma subtype.
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Affiliation(s)
| | | | - Adewale B. Ajumobi
- University of California, Riverside, USA
- Eisenhower Health, Rancho Mirage, CA, USA
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2
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Alvi AT, Shankar M. A Rare Case of Primary Extra-Nodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue (MALT) in the Rectum. Cureus 2023; 15:e49447. [PMID: 38149148 PMCID: PMC10751178 DOI: 10.7759/cureus.49447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 12/28/2023] Open
Abstract
Mucosa-associated lymphoid tissue (MALT) is a unique clinical condition that can manifest in different anatomic locations. In the gastrointestinal tract, it is typically seen in the stomach but is less commonly found in other sites. There have been a few cases in the literature in which primary MALT lymphoma is found in the rectum. We describe a case of a 63-year-old male who presented with rectal pain and bleeding. Colonoscopy revealed a rectal mass, which was excised with a trans-anal approach. Histopathological examination of the biopsy specimen was significant for MALT lymphoma. Therefore, the patient underwent radiation therapy followed by repeat colonoscopies to monitor disease recurrence.
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Affiliation(s)
- Ali Tariq Alvi
- Internal Medicine, HCA Florida Westside Hospital, Plantation, USA
- Internal Medicine, HCA Florida Northwest Hospital, Margate, USA
| | - Murali Shankar
- Internal Medicine, HCA Florida Westside Hospital, Plantation, USA
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3
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Chen D, Zhong DF, Yang Y, Chen SS, Liu D. Colonic mucosa-associated lymphoid tissue lymphoma: A case report. Front Surg 2023; 10:1178394. [PMID: 37181595 PMCID: PMC10169616 DOI: 10.3389/fsurg.2023.1178394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/22/2023] [Indexed: 05/16/2023] Open
Abstract
Background Mucosa-associated lymphoid tissue (MALT) lymphoma is a group of extranodal lymphomas that originate from B cells. Primary colonic MALT lymphoma is a rare disease, and there is no consensus on its endoscopic features and standard therapies. It is essential to raise awareness of colonic MALT lymphoma and choose the appropriate treatment. Case presentation In this case report, we describe a 0-IIb-type lesion that was found by electronic staining endoscopy and magnifying endoscopy. The patient underwent a definitive diagnostic ESD for diagnosis. The patient was evaluated for lymphoma after diagnostic ESD according to the Lugano 2014 evaluation criteria, which are divided into imaging remission on the basis of CT and/or magnetic resonance imaging (MRI) evaluation and metabolic remission on the basis of PET-CT evaluation. Based on the PET-CT results suggesting increased glucose metabolism in the sigmoid colon, the patient underwent additional surgical treatment. According to the pathological results of the surgery, we found that ESD could treat such lesions, which may provide a new option for colorectal MALT lymphoma. Conclusion The low incidence of colorectal MALT lymphoma, especially for 0-IIb lesions, which are difficult to detect, requires the use of electronic staining endoscopy to improve the detection rate. The combination with magnification endoscopy can improve the understanding of colorectal MALT lymphoma, which ultimately requires pathological support for diagnosis. According to our experience with the present patient case, ESD seems to be a feasible and economical choice for the treatment of massive colorectal MALT lymphoma. However, the combined application of ESD and another therapy scheme needs further clinical investigation.
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Affiliation(s)
- Dan Chen
- Department of Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People's Hospital, Jinhua, China
| | - Ding-Fu Zhong
- Department of Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People's Hospital, Jinhua, China
| | - Yi Yang
- Department of Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People's Hospital, Jinhua, China
| | - Si-Shuang Chen
- Department of Pathology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People's Hospital, Jinhua, China
| | - Dong Liu
- Department of Hepatobiliary and Pancreatic Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People's Hospital, Jinhua, China
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4
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Soma LA, Smith SD, Reddy P, Edlefsen KL, Wu D, Cherian S, Chen X, Zhou Y, Reddi D, Fromm JR. Clinicopathologic Findings in Patients With Initial Diagnosis of Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue (MALT) in Colorectal Mucosa. Am J Clin Pathol 2022; 157:23-32. [PMID: 34463316 DOI: 10.1093/ajcp/aqab089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/22/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To evaluate clinicopathologic features, management, and behavior of colorectal extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT). METHODS Clinical data, laboratory studies, and radiographic records were reviewed (2005-2018), and fluorescence in situ hybridization studies were performed. RESULTS Eleven patients were identified, six of whom were discovered as an incidental finding on endoscopy. Morphologic and immunophenotypic features were similar to MALT lymphomas at other sites except that lymphoepithelial lesions were uncommon. Three of nine patients were positive for BIRC3/MALT1 fusions, two of whom had identical B-cell clones identified in subsequent gastric biopsy specimens. Eight of 10 patients had no clinically evaluable disease after observation (±antibiotics; n = 4) or radiation/chemotherapy (n = 4). CONCLUSIONS Patients with incidental and localized colonic MALT lymphoma demonstrated an excellent prognosis with conservative management, although longer follow-up and data based on consistent staging and surveillance methods (including gastric evaluation) are necessary for informed management.
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Affiliation(s)
- Lorinda A Soma
- Department of Laboratory Medicine and Pathology, School of Medicine, Seattle, WA, USA
| | - Stephen D Smith
- Department of Internal Medicine, Division of Medical Oncology, University of Washington, Seattle, WA, USA
| | - Prathima Reddy
- Department of Internal Medicine, Division of Medical Oncology, University of Washington, Seattle, WA, USA
| | - Kerstin L Edlefsen
- Department of Laboratory Medicine and Pathology, School of Medicine, Seattle, WA, USA
| | - David Wu
- Department of Laboratory Medicine and Pathology, School of Medicine, Seattle, WA, USA
| | - Sindhu Cherian
- Department of Laboratory Medicine and Pathology, School of Medicine, Seattle, WA, USA
| | - Xueyan Chen
- Department of Laboratory Medicine and Pathology, School of Medicine, Seattle, WA, USA
| | - Yi Zhou
- Department of Pathology, School of Medicine, University of Miami, Miami, FL, USA
| | - Deepti Reddi
- Department of Laboratory Medicine and Pathology, School of Medicine, Seattle, WA, USA
| | - Jonathan R Fromm
- Department of Laboratory Medicine and Pathology, School of Medicine, Seattle, WA, USA
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5
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Yoon BH, Huh CW. [Rectal Mucosa-associated Lymphoid Tissue Lymphoma Treated with Endoscopic Resection]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2021; 78:344-348. [PMID: 34955511 DOI: 10.4166/kjg.2021.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/29/2021] [Accepted: 10/18/2021] [Indexed: 11/03/2022]
Abstract
A primary extranodal B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) is a distinct clinical-pathological entity that develops in diverse anatomic locations. However, colorectal involvement is rare. The authors encountered a case of a MALT lymphoma of the rectum in a 69-year-old woman who complained of up to 3 kg weight loss during 3 months. A colonoscopy demonstrated a 1.0×1.0 cm sized subepithelial tumor (SET) at the lower rectum. The patient underwent an endoscopic mucosal resection with ligation for the SET. Pathological analysis revealed marked small to medium-sized lymphocytic infiltration. Immunohistochemistry revealed neoplastic cells positive for CD20 and bcl-2. A polymerase chain reaction detected immunoglobulin H gene rearrangement. Finally, rectal MALT lymphoma was diagnosed. Computed tomography and positron emission tomography scans showed that there was no lymph node metastasis or other organ involvement. A bone marrow biopsy was found to be negative for any neoplastic process. Therefore, the Ann Arbor stage was IeB. Helicobacter pylori (H. pylori) was not detected in the gastric biopsy specimens. Thus far, she has had no relapse since the endoscopic resection. The incidence of rectal MALT is very rare, and treatment is unclear. This paper reports a case of rectal MALT lymphoma treated successfully with only an endoscopic resection.
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Affiliation(s)
- Baek Hyun Yoon
- Division of Gastroenterology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Cheal Wung Huh
- Division of Gastroenterology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
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6
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Li JJ, Chen BC, Dong J, Chen Y, Chen YW. Synchronous colonic mucosa-associated lymphoid tissue lymphoma found after surgery for adenocarcinoma: A case report and review of literature. World J Clin Cases 2020; 8:6456-6464. [PMID: 33392331 PMCID: PMC7760443 DOI: 10.12998/wjcc.v8.i24.6456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/11/2020] [Accepted: 10/26/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Mucosa-associated lymphoid tissue (MALT) lymphoma is a subtype of non-Hodgkin lymphoma that is mainly involved in the gastrointestinal tract. The synchronous occurrence of colonic MALT lymphoma and adenocarcinoma in the same patient is extremely rare. We here report a case of synchronous colonic MALT lymphoma found on surveillance colonoscopy five months after surgery and chemotherapy for sigmoid adenocarcinoma.
CASE SUMMARY A 67-year-old man was admitted because of hematochezia for two months. Colonoscopy suggested a colonic tumor before hospitalization. Abdominal computed tomography (CT) revealed local thickening of the sigmoid colon. The patient underwent a left hemicolectomy with local lymph node dissection. The histopathology revealed moderately differentiated adenocarcinoma and partially mucinous adenocarcinoma. The pTNM stage was T3N1Mx. The patient received chemotherapy with six cycles of mFOLFOX6 after surgery. Colonoscopy was performed five months later and revealed single, flat, polypoid lesions of the colon 33 cm away from the anus. Subsequently, the patient underwent endoscopic mucosal resection for further diagnosis. The pathological diagnosis was MALT lymphoma. Positron emission tomography /CT suggested metastasis. The patient refused further treatment and died ten months later.
CONCLUSION Colonic MALT lymphoma may occur after surgery and chemotherapy for adenocarcinoma as a synchronous malignancy. Regular surveillance colonoscopy and careful monitoring after surgery are critical.
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Affiliation(s)
- Juan-Juan Li
- Department of Intensive Care Unit and Comprehensive Support, Wang-Jiang-Shan Branch of Zhejiang Provincial People's Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Bing-Chen Chen
- Department of Colorectal Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Jie Dong
- Department of Gastroenterology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Yuan Chen
- Department of Pathology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - You-Wei Chen
- Department of Gastroenterology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
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7
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Melenotte C, Mezouar S, Mège JL, Gorvel JP, Kroemer G, Raoult D. Bacterial infection and non-Hodgkin's lymphoma. Crit Rev Microbiol 2020; 46:270-287. [PMID: 32412856 DOI: 10.1080/1040841x.2020.1760786] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
One quarter of all cancers are linked to infectious diseases. The link between viral infection and cancer has been widely studied, but few reports have focused on the carcinogenic role of bacterial infection. Nonetheless, Helicobacter pylori, Chlamydia psittaci, Coxiella burnetii, Borrelia burgdorferi and Campylobacter jejuni are bacteria that can be associated with non-Hodgkin's lymphoma (NHL), the most common haematologic malignancy. Here, we review the evidence in favour of a link between these bacterial infections and NHL. Sero-epidemiological observation makes it possible to identify a link between H. pylori, C. burnetii, B. burgdorferi infection and NHL. Helicobacter pylori, Chlamydia psittaci, Coxiella burnetii, Borrelia burgdorferi and Campylobacter jejuni could be identified in NHL tissue samples at the site of chronic inflammation, where B and T lymphocytes are attracted to participate in follicle formation. Lymphoma remissions have been observed under antimicrobial therapies supporting the carcinogenic contribution of bacteria. If the theory of causality is characterized by the lack of universal criteria for establishing a causal link between two diseases, infection and lymphoma, epidemiological, clinical, and histological evidences reported here, should lead clinicians to pay attention to these infectious agents, to detect early lymphoma transformation.
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Affiliation(s)
- Cléa Melenotte
- Aix-Marseille University, IRD, APHM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Soraya Mezouar
- Aix-Marseille University, IRD, APHM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Jean-Louis Mège
- Aix-Marseille University, IRD, APHM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | | | - Guido Kroemer
- Cell Biology and Metabolomics platforms, Villejuif, France.,INSERM, Paris, France.,Equipe 11 labellisée par la Ligue contre le Cancer, Centre de Recherche des Cordeliers, Paris, France.,Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Université Pierre et Marie Curie, Paris, France.,Pôle de Biologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.,Karolinska Institute, Department of Women's and Children's Health, Karolinska University Hospital, Stockholm, Sweden
| | - Didier Raoult
- Aix-Marseille University, IRD, APHM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
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8
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Tannoury J, Amiot A, Lemonnier F, Dupuis J, Gagnière C, Belhadj K, Bras FL, Sobhani I, Haioun C, Copie-Bergman C, Lévy M. Colonic mucosa-associated lymphoid tissue lymphoma: a case series. Leuk Lymphoma 2019; 61:582-587. [PMID: 31694428 DOI: 10.1080/10428194.2019.1686501] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
= 1). Remission was achieved in 8 cases. Three patients relapsed, and 2 were re-treated. At the end of the study period, 67% of the patients were in remission. All patients were symptom-free. This current series of colonic MALT lymphomas shows the indolent nature of the disease, which may be treated with various modalities.
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Affiliation(s)
- Jenny Tannoury
- Department of Gastroenterology, Groupe Hospitalier Henri Mondor-Albert Chenevier, APHP, Créteil, France.,Faculté de Médecine, Université Paris Est-Créteil (UPEC), Créteil, France.,EC2M3-EA7375 Research Unit, Créteil, France
| | - Aurélien Amiot
- Department of Gastroenterology, Groupe Hospitalier Henri Mondor-Albert Chenevier, APHP, Créteil, France.,Faculté de Médecine, Université Paris Est-Créteil (UPEC), Créteil, France.,EC2M3-EA7375 Research Unit, Créteil, France
| | - François Lemonnier
- Faculté de Médecine, Université Paris Est-Créteil (UPEC), Créteil, France.,Unit UMR-S 955, INSERM, Créteil, France.,Lymphoid Malignancies Unit, Groupe Hospitalier Henri Mondor-Albert Chenevier, APHP, Créteil, France
| | - Jehan Dupuis
- Lymphoid Malignancies Unit, Groupe Hospitalier Henri Mondor-Albert Chenevier, APHP, Créteil, France
| | - Charlotte Gagnière
- Department of Gastroenterology, Groupe Hospitalier Henri Mondor-Albert Chenevier, APHP, Créteil, France.,Faculté de Médecine, Université Paris Est-Créteil (UPEC), Créteil, France.,EC2M3-EA7375 Research Unit, Créteil, France
| | - Karim Belhadj
- Lymphoid Malignancies Unit, Groupe Hospitalier Henri Mondor-Albert Chenevier, APHP, Créteil, France
| | - Fabien Le Bras
- Lymphoid Malignancies Unit, Groupe Hospitalier Henri Mondor-Albert Chenevier, APHP, Créteil, France
| | - Iradj Sobhani
- Department of Gastroenterology, Groupe Hospitalier Henri Mondor-Albert Chenevier, APHP, Créteil, France.,Faculté de Médecine, Université Paris Est-Créteil (UPEC), Créteil, France.,EC2M3-EA7375 Research Unit, Créteil, France
| | - Corinne Haioun
- Faculté de Médecine, Université Paris Est-Créteil (UPEC), Créteil, France.,Unit UMR-S 955, INSERM, Créteil, France.,Lymphoid Malignancies Unit, Groupe Hospitalier Henri Mondor-Albert Chenevier, APHP, Créteil, France
| | - Christiane Copie-Bergman
- Faculté de Médecine, Université Paris Est-Créteil (UPEC), Créteil, France.,Unit UMR-S 955, INSERM, Créteil, France.,Department of Pathology, Groupe Hospitalier Henri Mondor-Albert Chenevier, APHP, Créteil, France
| | - Michaël Lévy
- Department of Gastroenterology, Groupe Hospitalier Henri Mondor-Albert Chenevier, APHP, Créteil, France.,EC2M3-EA7375 Research Unit, Créteil, France
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9
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Kato M, Ota H, Okuda M, Kikuchi S, Satoh K, Shimoyama T, Suzuki H, Handa O, Furuta T, Mabe K, Murakami K, Sugiyama T, Uemura N, Takahashi S. Guidelines for the management of Helicobacter pylori infection in Japan: 2016 Revised Edition. Helicobacter 2019; 24:e12597. [PMID: 31111585 DOI: 10.1111/hel.12597] [Citation(s) in RCA: 176] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/08/2019] [Accepted: 04/14/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Since "Helicobacter pylori (H. pylori) infection" was set as the indication in the Japanese Society for Helicobacter Research (JSHR) Guidelines 2009, eradication treatment for H. pylori gastritis is covered under insurance since 2013 in Japan, and the number of H. pylori eradication has rapidly increased. Under such circumstances, JSHR has made the third revision to the "Guidelines for diagnosis and treatment of H. pylori infection" for the first time in 7 years. METHODS The Guideline Committee held 10 meetings. Articles published between the establishment of the 2009 Guidelines and March 2016 were reviewed and classified according to the evidence level; the statements were revised on the basis of this review. After inviting public comments, the revised statements were finalized using the Delphi method. RESULTS There was no change in the basic policy that H. pylori infectious disease is an indication for eradication. Other diseases presumed to be associated with H. pylori infection were added as indications. Serum pepsinogen level, endoscopic examination, and X-ray examination were added to the diagnostic methods. The effects of 1-week triple therapy consisting of potassium-competitive acid blocker (P-CAB), amoxicillin, and clarithromycin have improved, and high eradication rates can also be expected with proton pump inhibitors (PPI) or P-CAB combined with amoxicillin and metronidazole. If the susceptibility test is not performed, the triple PPI or P-CAB/amoxicillin/metronidazole therapy should be chosen, because the PPI/amoxicillin/metronidazole combination demonstrated a significantly higher eradication rate than PPI/amoxicillin/clarithromycin. In the proposal for gastric cancer prevention, we divided gastric cancer prevention measures by age from adolescent to elderly, who are at an increased gastric cancer risk, and presented measures for gastric cancer prevention primarily based on H. pylori eradication. CONCLUSION We expect the revised guidelines to facilitate appropriate interventions for patients with H. pylori infection and accomplish its eradication and prevention of gastric cancer.
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Affiliation(s)
- Mototsugu Kato
- Department of Gastroenterology, National Hospital Organization Hakodate National Hospital, Hakodate, Hokkaido, Japan
| | - Hiroyoshi Ota
- Department of Clinical Laboratory Sciences, Shinshu University School of Medicine, Nagano, Hyogo, Japan
| | - Masumi Okuda
- Department of Pediatrics, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Shogo Kikuchi
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Kiichi Satoh
- Department of Gastroenterology, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, Japan
| | | | - Hidekazu Suzuki
- Fellowship Training Center, Medical Education Center, Keio University School of Medicine, Tokyo, Japan
| | - Osamu Handa
- Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takahisa Furuta
- Center for Clinical Research, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Katsuhiro Mabe
- Department of Gastroenterology, National Hospital Organization Hakodate National Hospital, Hakodate, Hokkaido, Japan
| | - Kazunari Murakami
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Toshiro Sugiyama
- Department of Cancer Prevention and Therapeutics, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Naomi Uemura
- Department of Gastroenterology, Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa, Japan
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10
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Takeuchi Y, Miyahara K, Morito T, Okikawa Y, Kinugasa H, Moritou Y, Higashi R, Kunihiro M, Nakagawa M. The Progression of Esophageal Mucosa-associated Lymphoid Tissue Lymphoma after Helicobacter pylori Eradication Therapy: A Case Report and Discussion of Therapeutic Options. Intern Med 2019; 58:207-212. [PMID: 30146577 PMCID: PMC6378146 DOI: 10.2169/internalmedicine.1112-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 50-year-old woman with epigastric discomfort was referred to our hospital. Esophagogastroduodenoscopy showed flat, elevated, submucosal tumor-like lesions in the esophagus. Extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) of the esophagus was diagnosed based on the examination of an endoscopic biopsy specimen. Computed tomography showed the enlargement of a lymph node in the gastric cardia. The present case showed disease progression despite Helicobacter pylori eradication therapy and achieved partial remission after rituximab monotherapy. The patient remained in partial remission for 20 months. This case suggests that esophageal MALT lymphoma with lymph node involvement does not respond to H. pylori eradication therapy and that it requires systemic treatment.
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Affiliation(s)
- Yukari Takeuchi
- Department of Internal Medicine, Hiroshima City Hospital, Japan
| | - Koji Miyahara
- Department of Internal Medicine, Hiroshima City Hospital, Japan
| | | | | | | | - Yuki Moritou
- Department of Internal Medicine, Hiroshima City Hospital, Japan
| | - Reiji Higashi
- Department of Internal Medicine, Hiroshima City Hospital, Japan
| | - Masaki Kunihiro
- Department of Internal Medicine, Hiroshima City Hospital, Japan
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11
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Roh HJ, Procop GW, Batra PS, Citardi MJ, Lanza DC. Inflammation and the Pathogenesis of Inverted Papilloma. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/194589240401800201] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Despite existing clinical and histopathological evidence, the role of inflammation in the pathogenesis of inverted papilloma (IP) is not well understood. The goal of this study was to describe the inflammatory cell component present in sinonasal papilloma (SP), with the intention of further defining the existence of inflammation in IP and perhaps gaining insight into IP pathophysiology. Methods Computerized database analysis was performed to identify all patients with SP who underwent surgery at the Cleveland Clinic Foundation between 1995 and 2001. Histopathological features of all SP were reviewed and semiquantitative analysis of the inflammatory cells present was performed. IP was histopathologically graded into four categories by the extent of inflammatory infiltrate and cellular atypia. Statistical analysis of the inflammatory cell component present in the epithelial layer of exophytic papilloma and IP was performed. Results SP was classified into three types: cylindrical papilloma (5% [2/41]), exophytic squamous papilloma (34% [14/41]), and IP (61% [25/41]). Twenty-eight instances of IP in 25 patients were identified. Altogether, 11% were grade I (3/28), 54% were grade II (15/28), 25% were grade III (7/28), and 11% were grade IV (3/28). The inflammatory cell population was significantly greater in IP compared with other SPs and greater in grades I and II IP when compared with grade III and IV IP. Conclusion Inflammatory cells were identified as a significant cell population in IP, whereas it was less commonly encountered in other forms of SP. The proposed IP staging system may serve as the foundation for improved understanding of IP and, ultimately, may help to predict recurrence or apparent malignant transformation.
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Affiliation(s)
- Hwan-Jung Roh
- Department of Otolaryngology—Head and Neck Surgery, College of Medicine, Pusan National University, Pusan, Korea
| | - Gary W. Procop
- Departments of Pathology and Cleveland Clinic Foundation, Cleveland, Ohio
| | - Pete S. Batra
- Otolaryngology and Communicative Disorders, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Martin J. Citardi
- Otolaryngology and Communicative Disorders, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Donald C. Lanza
- Otolaryngology and Communicative Disorders, Cleveland Clinic Foundation, Cleveland, Ohio
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12
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De Sanctis V, Marignani M, Angeletti S, Assisi D, Armosini V, Valeriani M, Minniti G, Cox MC, Ruco L, Enrici RM. Anti-Helicobacter Pylori Therapy in Primary MALT Lymphoma of Rectum. TUMORI JOURNAL 2018; 98:e105-10. [DOI: 10.1177/030089161209800423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Primary rectal MALT lymphoma is a very rare entity among extranodal MALT lymphomas and its therapeutic management has not been standardized. Different approaches including surgery, chemotherapy and radiotherapy have been proposed in the last decades. There have been reports on complete responses after anti-Helicobacter pylori therapy, also in patients without serological or histological evidence of Helicobacter pylori infection. In our patient we obtained a complete response with anti-Helicobacter pylori therapy and a disease-free survival of 34 months. Endoscopic ultrasound was useful for diagnosis and follow-up. Although the mechanisms that determined this response remain a matter of debate, anti-Helicobacter pylori therapy can be considered as first-line therapy in stage IE, nonbulky primary rectal MALT lymphoma. Endoscopic ultrasound could play a relevant role in the management of this rare condition.
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Affiliation(s)
| | - Massimo Marignani
- Department of Digestive and Liver Disease, Sapienza University, S Andrea Hospital, Rome
| | - Stefano Angeletti
- Department of Digestive and Liver Disease, Sapienza University, S Andrea Hospital, Rome
| | - Daniela Assisi
- Department of Digestive and Liver Disease, Sapienza University, S Andrea Hospital, Rome
| | - Veronica Armosini
- Department of Radiotherapy, Sapienza University, S Andrea Hospital, Rome
| | - Maurizio Valeriani
- Department of Radiotherapy, Sapienza University, S Andrea Hospital, Rome
| | - Giuseppe Minniti
- Department of Radiotherapy, Sapienza University, S Andrea Hospital, Rome
| | | | - Luigi Ruco
- Hematology Unit, S Andrea Hospital, Rome
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Management of Asymptomatic Mucosa-Associated Lymphoid Tissue Lymphoma of the Colon Found Incidentally on Colonoscopy. Clin Gastroenterol Hepatol 2017; 15:1130-1132. [PMID: 28246052 DOI: 10.1016/j.cgh.2017.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/20/2017] [Accepted: 02/21/2017] [Indexed: 02/07/2023]
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14
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Abbas H, Niazi M, Makker J. Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma of the Colon: A Case Report and a Literature Review. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:491-497. [PMID: 28469125 PMCID: PMC5424574 DOI: 10.12659/ajcr.902843] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Patient: Female, 56 Final Diagnosis: Colonic MALT lymphoma Symptoms: Epigastric pain Medication: — Clinical Procedure: Colonoscopy and biopsy Specialty: Gastroenterology and Hepatology
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Affiliation(s)
- Hafsa Abbas
- Department of Medicine, Bronx Lebanon Hospital Center, Bronx, USA
| | - Masooma Niazi
- Department of Pathology, Bronx Lebanon Hospital Center, Bronx, USA
| | - Jasbir Makker
- Department of Medicine, Division of Gastroenterology, Bronx Lebanon Hospital Center, Bronx, USA
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15
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Kelley SR. Mucosa-associated lymphoid tissue (MALT) variant of primary rectal lymphoma: a review of the English literature. Int J Colorectal Dis 2017; 32:295-304. [PMID: 27995323 DOI: 10.1007/s00384-016-2734-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2016] [Indexed: 02/08/2023]
Abstract
PURPOSE Primary rectal lymphoma (PRL) is the third most common cause of rectal cancer following adenocarcinoma (90-95 %) and carcinoid (5 %). The most common variant of PRL is the mucosa-associated lymphoid tissue (MALT) type. To date, no study has been able to recommend an optimal treatment algorithm for this rare disease. The aim of our study was to review the English literature on primary rectal MALT lymphoma. METHODS A review of the English literature was conducted to identify articles describing the MALT variant of PRL. RESULTS Fifty-one cases were identified. A complete response was achieved in 12 of 19 cases treated with Helicobacter pylori eradication therapy, 5 of 6 with radiation, 2 of 4 cases with chemotherapy, 2 of 4 with endoscopic resection, 6 of 8 cases with surgical resection, and all 8 with combination therapies. Cases failing initial therapies were responsive to various second-line treatments. Two cases spontaneously regressed with observation alone. CONCLUSION Complete regression of primary rectal MALT lymphoma was achieved using various therapeutic strategies, although the numbers of different treatment modalities are too small to draw definitive conclusions.
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Affiliation(s)
- Scott R Kelley
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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16
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Ramavaram S, Velchala N, Levy R, Rego RF. Malt lymphoma of the colon: a rare occurrence. J Gastrointest Cancer 2015; 45 Suppl 1:29-32. [PMID: 23912606 DOI: 10.1007/s12029-013-9526-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Samyuktha Ramavaram
- Division of Gastroenterology, University of Arkansas for Medical sciences, Little Rock, AR, USA
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17
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Ferreri A, Sassone M, Kiesewetter B, Govi S, Scarfò L, Donadoni G, Raderer M. High-dose clarithromycin is an active monotherapy for patients with relapsed/refractory extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT): the HD-K phase II trial. Ann Oncol 2015; 26:1760-5. [DOI: 10.1093/annonc/mdv214] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 04/22/2015] [Indexed: 11/13/2022] Open
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18
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Wotherspoon AC, Du MQ, Spencer J. Gastrointestinal Lymphoma. Mucosal Immunol 2015. [DOI: 10.1016/b978-0-12-415847-4.00089-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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19
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Vetro C, Romano A, Amico I, Conticello C, Motta G, Figuera A, Chiarenza A, Raimondo CD, Giulietti G, Bonanno G, Palumbo GA, Raimondo FD. Endoscopic features of gastro-intestinal lymphomas: From diagnosis to follow-up. World J Gastroenterol 2014; 20:12993-13005. [PMID: 25278693 PMCID: PMC4177478 DOI: 10.3748/wjg.v20.i36.12993] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 02/28/2014] [Accepted: 05/29/2014] [Indexed: 02/06/2023] Open
Abstract
Many progresses have been done in the management of gastrointestinal (GI) lymphomas during last decades, especially after the discovery of Helicobacter pylori-dependent lymphoma development. The stepwise implementation of new endoscopic techniques, by means of echoendoscopy or double-balloon enteroscopy, enabled us to more precisely describe the endoscopic features of GI lymphomas with substantial contribution in patient management and in tailoring the treatment strategy with organ preserving approaches. In this review, we describe the recent progresses in GI lymphoma management from disease diagnosis to follow-up with a specific focus on the endoscopic presentation according to the involved site and the lymphoma subtype. Additionally, new or emerging endoscopic technologies that have an impact on the management of gastrointestinal lymphomas are reported. We here discuss the two most common subtypes of GI lymphomas: the mucosa-associated lymphoid tissue and the diffuse large B cell lymphoma. A general outline on the state-of-the-art of the disease and on the role of endoscopy in both diagnosis and follow-up will be performed.
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MESH Headings
- Animals
- Endoscopy, Gastrointestinal
- Endosonography
- Helicobacter Infections/complications
- Helicobacter Infections/microbiology
- Helicobacter pylori/pathogenicity
- Humans
- Intestinal Neoplasms/diagnostic imaging
- Intestinal Neoplasms/microbiology
- Intestinal Neoplasms/pathology
- Intestinal Neoplasms/therapy
- Lymphoma, B-Cell, Marginal Zone/diagnostic imaging
- Lymphoma, B-Cell, Marginal Zone/microbiology
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/therapy
- Lymphoma, Large B-Cell, Diffuse/diagnostic imaging
- Lymphoma, Large B-Cell, Diffuse/microbiology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Neoplasm Grading
- Predictive Value of Tests
- Stomach Neoplasms/diagnostic imaging
- Stomach Neoplasms/microbiology
- Stomach Neoplasms/pathology
- Stomach Neoplasms/therapy
- Treatment Outcome
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20
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Jain V, Misra S, Ahmad F, Rahul K, Singh A. MALT Lymphoma of Caecum Presenting as Acute Intestinal Obstruction: A Case Report. Indian J Surg 2012; 75:286-9. [PMID: 24426593 DOI: 10.1007/s12262-012-0672-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 06/21/2012] [Indexed: 02/06/2023] Open
Abstract
Mucosa-associated lymphoid tissue lymphomas (MALT lymphoma) are well known, but colonic MALT lymphomas are extremely rare. We report the first case of mucosa-associated lymphoid tissue (MALT) lymphoma in the cecum from India presenting as acute intestinal obstruction with mass in right iliac fossa showing diffuse thickening of ascending colon and caecum with obliterated lumen along with nodular mass on CECT scan of abdomen. On video colonoscopy, circumferential ulcerated growth was seen at cecum, and the rest of the colon was normal. Multiple biopsies from growth suggested malignancy. Right hemicolectomy was performed. The histopathology of resected specimen demonstrated low-grade B-cell MALT lymphoma of the cecum, and the depth of invasion was up to the muscular layer. This was confirmed by immunohistochemistry.
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Affiliation(s)
- Vinod Jain
- Department of Surgery, C. S. M. Medical University, B-41, Mahanagar Extension, Lucknow, UP India 226006
| | - Samir Misra
- Department of Surgery, C. S. M. Medical University, B-41, Mahanagar Extension, Lucknow, UP India 226006
| | - Faraz Ahmad
- Department of Surgery, C. S. M. Medical University, B-41, Mahanagar Extension, Lucknow, UP India 226006
| | - Kumar Rahul
- Department of Surgery, C. S. M. Medical University, B-41, Mahanagar Extension, Lucknow, UP India 226006
| | - Amit Singh
- Department of Surgery, C. S. M. Medical University, B-41, Mahanagar Extension, Lucknow, UP India 226006
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21
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Ohara E, Kitadai Y, Onoyama M, Ohnishi M, Shinagawa K, Oka S, Yoshida S, Tanaka S, Sakamoto N, Yasui W, Shimamoto F, Chayama K. Regression of rectal MALT lymphoma after antibiotic treatment in a patient negative for Helicobacter pylori. Clin J Gastroenterol 2011; 5:59-63. [PMID: 26181877 DOI: 10.1007/s12328-011-0270-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Accepted: 10/10/2011] [Indexed: 01/31/2023]
Abstract
A 53-year-old man was referred to our hospital with bloody stool. Barium enema study and colonoscopy revealed multiple small nodules on the anterior wall of the lower rectum. Biopsy specimens showed proliferation of atypical lymphoid cells forming the nodules. Mucosa-associated lymphoid tissue lymphoma was diagnosed on the basis of histologic and immunohistochemical examinations. No metastasis was detected in lymph nodes or distant organs, indicative of clinical stage I disease. Although the test results were negative for Helicobacter pylori, eradication therapy was performed. The lesion disappeared completely within 9 months after the triple antibiotic therapy. H. pylori eradication therapy may be a useful treatment option regardless of H. pylori status.
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Affiliation(s)
- E Ohara
- Department of Gastroenterology and Metabolism, Hiroshima University Graduate School of Biomedical Science, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Y Kitadai
- Department of Gastroenterology and Metabolism, Hiroshima University Graduate School of Biomedical Science, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
| | - M Onoyama
- Department of Gastroenterology and Metabolism, Hiroshima University Graduate School of Biomedical Science, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - M Ohnishi
- Department of Gastroenterology and Metabolism, Hiroshima University Graduate School of Biomedical Science, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - K Shinagawa
- Department of Gastroenterology and Metabolism, Hiroshima University Graduate School of Biomedical Science, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - S Oka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - S Yoshida
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - S Tanaka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - N Sakamoto
- Department of Molecular Pathology, Hiroshima University Graduate School of Biomedical Science, Hiroshima, Japan
| | - W Yasui
- Department of Molecular Pathology, Hiroshima University Graduate School of Biomedical Science, Hiroshima, Japan
| | - F Shimamoto
- Department of Health Science, Faculty of Human Culture and Society, Prefectural University of Hiroshima, Hiroshima, Japan
| | - K Chayama
- Department of Gastroenterology and Metabolism, Hiroshima University Graduate School of Biomedical Science, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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22
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Watanabe T, Suda T, Hirono H, Hasegawa K, Soga K, Shibasaki K, Umezu H. Successful treatment of mucosa-associated lymphoid tissue lymphoma in a patient with gastric and rectal lesions with metachronous and ectopic development. Rare Tumors 2011; 3:e24. [PMID: 21769323 PMCID: PMC3132128 DOI: 10.4081/rt.2011.e24] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 05/18/2011] [Accepted: 05/19/2011] [Indexed: 12/21/2022] Open
Abstract
A 75-year-old female, who had an abnormal stomach x-ray finding, was admitted to the hospital for further examination and therapy. Upper GI endoscopy showed reddish and swollen folds on the greater curvature of the gastric body and a biopsy was of this lesion revealed malignant lymphoma (small cell type or mucosa-associated lymphoid tissue (MALT) lymphoma suspected). The patient was infected with Helicobacter pylori (H. pylori), however, in response to the patient's wishes, a total gastrectomy, omentectomy and splenectomy were performed and the histological diagnosis was gastric MALT lymphoma. Two courses of CHOP therapy (cyclophosphamide (CPM) 750 mg/m2/day, day 1, adriamycin (ADM) 50 mg/m2/day, day 1, vincristine sulfate (VCR) 1.4 mg/m2/day, day 1, prednisolone 100 mg/body, day 1–5) were administered as adjuvant chemotherapy. A colonoscopic examination performed about 4.5 yr after the operation revealed rectal submucosal tumors and the biopsied specimens were diagnosed as malignant lymphoma. A transanal focal resection was performed and the histological diagnosis was metachronous and ectopic development of MALT lymphoma. The histological finding was similar to the gastric lesion. About 4 and 7 yr after the first development of rectal MALT lymphoma, MALT lymphomas developed repeatedly in the rectal lesion, however, these were resected repeatedly and no developmenthas occurred during the past two years. This report presents a very rare case of metachronous and ectopic MALT lymphoma development in the gastric and rectal lesions.
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Affiliation(s)
- Takuya Watanabe
- Department of Internal Medicine and Gastroenterology, Medical Hospital, The Nippon Dental University School of Life Dentistry at Niigata, Niigata
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23
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Gisbert JP, Calvet X. Review article: common misconceptions in the management of Helicobacter pylori-associated gastric MALT-lymphoma. Aliment Pharmacol Ther 2011; 34:1047-62. [PMID: 21919927 DOI: 10.1111/j.1365-2036.2011.04839.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Helicobacter pylori infection is the main cause of gastric mucosa-associated lymphoid tissue (MALT) lymphoma. AIM To review several common misconceptions in the management of H. pylori-associated gastric MALT-lymphoma. METHODS Bibliographical searches were performed in MEDLINE up to June 2011. RESULTS If adequate diagnostic methods are used, and if only low-grade lymphomas are considered, the prevalence of H. pylori infection is very high (almost 90%). H. pylori eradication is effective in treating approximately 80% of patients with early stage lymphoma. In H. pylori-positive gastric high-grade lymphomas, antibiotic therapy should always be prescribed, as approximately 50% of them regress after H. pylori eradication. Patients with early stage MALT lymphoma negative for H. pylori might still benefit from antibiotic treatment as the sole treatment. Complete remission of gastric MALT lymphoma after H. pylori eradication can take even >12 months. PCR assay for the detection of monoclonal B cells remains positive in many cases after complete remission has been reached. Patients with a persistent clonal band should not be treated unless the lymphoma can be histologically demonstrated. Synchronous occurrence of gastric adenocarcinoma and MALT lymphoma has been repeatedly reported. In some patients in complete remission, eradication of H. pylori does not prevent later development of early gastric cancer. Gastric lymphoma recurrence occurs in some patients after both bacterial and lymphoma regression. H. pylori reinfection does not constitute a prerequisite for lymphoma recurrence. CONCLUSIONS The present article states several misconceptions in the management of H. pylori-associated gastric MALT-lymphoma in clinical practice, reviews the related scientific evidence and proposes the adequate attitude in each case.
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Affiliation(s)
- J P Gisbert
- Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Madrid, Spain.
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24
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Chahil N, Bloom P, Tyson J, Jazwari S, Robilotti J, Gaultieri N. Novel approach to treatment of rectal mucosa-associated lymphoid tissue lymphoma. BMJ Case Rep 2011; 2011:2969. [PMID: 22715275 DOI: 10.1136/bcr.05.2010.2969] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
A 78-year-old Hispanic woman with a medical history of osteoporosis, hyperlipidaemia and dyspepsia presented to a gastrointestinal clinic complaining of a small amount of rectal bleeding following bowel movements for 6 months. Colonoscopy demonstrated a 3×3 cm submucosal rectal mass. Pathological analysis revealed ulcerated colonic mucosa with diffuse proliferation suggestive of a lymphoproliferative process. Immunohistochemistry and flow cytometry of the specimen supported a diagnosis of mucosa-associated lymphoid tissue lymphoma. The patient was treated with amoxicillin, clarithromycin and lansoprazole for 2 weeks. A C-14 urea breath test confirmed eradication of Helicobacter pylori. Repeat colonoscopy showed no regression of the tumour. The patient received external beam radiation treatment. Subsequent positron emission tomography/CT scans demonstrated no evidence of viable tumour tissue and no regional or distant metastasis. Follow-up sigmoidoscopy with biopsy revealed no evidence of lymphoma.
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Affiliation(s)
- Neetu Chahil
- Medicine, St Vincent Catholic Medical Center, New York, USA
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25
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Niino D, Yamamoto K, Tsuruta O, Maeda T, Yakushijin Y, Aoki R, Kimura Y, Hashikawa K, Kiyasu J, Takeuchi M, Sugita Y, Ohshima K. Regression of rectal mucosa-associated lymphoid tissue (MALT) lymphoma after antibiotic treatments. Pathol Int 2010; 60:438-42. [PMID: 20518898 DOI: 10.1111/j.1440-1827.2010.02538.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Only a few reports have described regression of rectal mucosa-associated lymphoid tissue (MALT) lymphoma after antibiotic treatment are generally found to be successful for gastric tumors. We examined eight rectal MALT lymphomas treated with antibiotic treatments to determine whether they regressed after treatment. We also discuss the relationship between rectal MALT lymphomas and MALT1 gene genetic abnormalities. Eight patients who had undergone antibiotic treatments were followed up with colonoscopy after initiation of the treatment. In five of the eight cases (63%) endoscopic examination showed that the rectal tumor had disappeared, which was confirmed histologically. Polymerase chain reaction for immunoglobulin heavy chain identified a monoclonal band in seven of eight cases (88%). Of the eight cases analyzed with fluorescence in situ hybridization (FISH) for MALT1 translocation, two demonstrated MALT1 gene genetic abnormality. These cases tended to be resistant to antibiotic treatment. Investigation and analysis of a large number of rectal MALT lymphomas are needed to establish suitable standards for antibiotic treatment.
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Affiliation(s)
- Daisuke Niino
- Department of Pathology, School of Medicine, Kurume University, Asahi-machi, Kurume, Japan.
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26
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Ersoz F, Toros AB, Bektas H, Ozcan O, Koc O, Arikan S. MALT lymphoma of the rectum, presenting with rectal prolapsus: a case report. CASES JOURNAL 2010; 3:33. [PMID: 20180989 PMCID: PMC2828431 DOI: 10.1186/1757-1626-3-33] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2009] [Accepted: 01/21/2010] [Indexed: 02/07/2023]
Abstract
Up to now, there have been only a few reported cases of Mucosa-associated lymphoid tissue (MALT) lymphomas arising in the rectum. Its clinical presentation is indistinguishable from that of rectal carcinoma but the treatment is apparently different. Symptoms of primary lymphomas involving the rectum include; anorexia, weight loss, change in bowel habits, obstruction, and bleeding. These symptoms are not disease specific and can be seen in many other gastrointestinal disorders. Patients with polypoid masses may present with obstruction symptoms. In this rare case, a female patient admitted to the emergency service with prolapsus of a rectal mass. The optimal treatment of rectal MALT lymphoma is not well defined yet, given the rarity of the disease. Surgical resection of the localized lesion and following adjuvant chemotherapy has proved to be an effective treatment option. However, a close and long-lasting follow-up is important.
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Affiliation(s)
- Feyzullah Ersoz
- Department of Gastroenterology, Istanbul Education and Research Hospital, Istanbul, Turkey.
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27
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Lee SY. Concerns about the Predictive Factors for Tumor Regression, Definition, and Management of Nonresponders, and Relapse of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma Related to Helicobacter pylori. Gut Liver 2009; 3:235-6. [PMID: 20431754 PMCID: PMC2852709 DOI: 10.5009/gnl.2009.3.3.235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2009] [Accepted: 06/07/2009] [Indexed: 11/25/2022] Open
Affiliation(s)
- Sun-Young Lee
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
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28
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Amouri A, Chtourou L, Mnif L, Mdhaffar M, Abid M, Ayedi L, Daoud J, Elloumi M, Boudawara T, Tahri N. [MALT lymphoma of the rectum: a case report treated by radiotherapy]. Cancer Radiother 2008; 13:61-4. [PMID: 19101191 DOI: 10.1016/j.canrad.2008.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2008] [Revised: 09/11/2008] [Accepted: 11/04/2008] [Indexed: 01/30/2023]
Abstract
The mucosa-associated lymphoid tissue (MALT) lymphoma is a distinct clinical pathologic entity that develops in diverse anatomic locations such as the stomach, salivary gland, thyroid, lung, skin and breast. However, colorectal involvement is extremely rare. To our knowledge, only ten cases of primary rectal MALT lymphoma have been reported in the literature. We report a 46-year-old woman with rectal MALT lymphoma, which regressed after radiotherapy. The patient had rectal bleeding. Colonoscopy showed a pseudonodular and ulcerated big fold in the rectum. Microscopic and immunohistologic studies of the biopsy specimen showed typical features of low grade MALT lymphoma. Upper endoscopy showed chronic gastritis with lymphoid follicles but without any infiltration of lymphoma cells. Helicobacter pylori infection was confirmed by histology. No extra-intestinal involvement was found on the staging evaluation, which included computed tomography (CT) of the abdomen, chest, pelvis and a bone marrow biopsy. We attempted to eradicate H. pylori with a 7-day course of omeprazole, amoxycillin, and metronidazole. Eradication was proved successful by endoscopy. Repeated colonoscopy 4 months after the end of treatment showed that the rectal tumor had not regressed. Biopsy specimens confirmed the persistent infiltration of lymphoma cells. The patient was considered to be a non-responder to eradication therapy and was indicated for radiotherapy. He underwent a total of 34 Gy. Complete regression was confirmed by colonoscopic and histologic examination at 2 months after the end of treatment. He was followed up closely with colonoscopy, but no relapse of these lesions was detected after 12 months.
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Affiliation(s)
- A Amouri
- Service d'hépatogastroentérologie, hôpital Hédi-Chaker, 3029 Sfax, Tunisie.
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29
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Foo M, Chao MWT, Gibbs P, Guiney M, Jacobs R. Successful treatment of mucosa-associated lymphoid tissue lymphoma of the rectum with radiation therapy: report of a case. Dis Colon Rectum 2008; 51:1719-23. [PMID: 18633678 DOI: 10.1007/s10350-008-9379-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2006] [Accepted: 12/27/2006] [Indexed: 02/08/2023]
Abstract
We report a case of Stage IE mucosa-associated lymphoid tissue lymphoma arising in the rectum, which was successfully treated with radiotherapy. A 60-year-old man had several months of altered bowel habit with rectal bleeding and was found to have a large rectal tumor with no evidence of distant spread. Histologic studies showed this to be a mucosa-associated lymphoid tissue lymphoma. The patient received 45 Gy in 25 fractions with external beam radiotherapy during 5 weeks. The treatment was well tolerated and review at 41 months revealed no evidence of recurrence.
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Affiliation(s)
- Marcus Foo
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, St. Andrew's Place, East Melbourne, Victoria, 3002, Australia.
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30
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Piotrowski R, Kramer R, Kamal A. Image of the month. Extranodal marginal zone B-cell (mucosa-associated lymphoid tissue) lymphoma of the colon presenting as an obstructing mass. Clin Gastroenterol Hepatol 2008; 6:e18-9. [PMID: 18308643 DOI: 10.1016/j.cgh.2007.12.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Rebecca Piotrowski
- Department of Medicine, Santa Clara Valley Medical Center, San Jose, California, USA
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Troch M, Püspök A, Streubel B, Chott A, Raderer M. Second complete remission of Helicobacter pylori negative gastric MALT lymphoma following antibiotic treatment. Leuk Lymphoma 2007; 48:204-6. [PMID: 17325871 DOI: 10.1080/10428190601016142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ahlawat S, Kanber Y, Charabaty-Pishvaian A, Ozdemirli M, Cohen P, Benjamin S, Haddad N. Primary mucosa-associated lymphoid tissue (MALT) lymphoma occurring in the rectum: a case report and review of the literature. South Med J 2007; 99:1378-84. [PMID: 17233195 DOI: 10.1097/01.smj.0000215855.98512.9d] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The primary extranodal B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) is a distinct clinical pathologic entity that develops in diverse anatomic locations such as the stomach, salivary gland, thyroid, lung, and breast; however, colorectal involvement is rare. To the best of our knowledge, only 30 cases of primary rectal MALT lymphoma have been published in the English language literature, mostly from Japan. A single case has been reported from the US before this report. The most common symptoms ranged from asymptomatic to occult or gross gastrointestinal bleeding. Simultaneous involvement of the cecum or colon was seen in 20% of the patients. Ninety percent of the patients were classified as low grade, Stage 1 at the time of diagnosis. Polypoid lesions were 10-fold more common than ulcerative lesions. Seven patients were reported to have H pylori in the stomach. The majority of the patients underwent surgical or endoscopic resection as a cure; however, controversy exists with regards to antibiotic treatment or observation alone because of unknown etiopathogenesis. Infection with microorganisms other than H pylori has been postulated in the development of rectal MALT lymphoma; however, this hypothesis remains unproven. The overall prognosis of rectal MALT lymphoma appears favorable; however, long-term follow-up data is lacking. Therefore, periodic clinical monitoring should be done in these patients.
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Affiliation(s)
- Sushil Ahlawat
- Division of Gastroenterology, Department of Pathology, Georgetown University Hospital, 3800 Reservoir Road, NW, Washington, DC 20007, USA
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Dickson BC, Serra S, Chetty R. Primary gastrointestinal tract lymphoma: diagnosis and management of common neoplasms. Expert Rev Anticancer Ther 2007; 6:1609-28. [PMID: 17134365 DOI: 10.1586/14737140.6.11.1609] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Primary gastrointestinal lymphoma represents the most common location of extranodal lymphoma. With the bulk of disease manifesting within the gastrointestinal tract and contiguous lymph nodes, many of the lymphomas occurring in the peripheral lymph nodes can also present with primary gastrointestinal tract involvement. Molecular biology has recently enabled significant progress in the diagnosis and management of primary gastrointestinal lymphoma. Herein, we will discuss the major lymphomas affecting the bowel and highlight their key morphological, immunophenotypical and molecular diagnostic attributes. Similarly, in keeping with recent therapeutic advances, we will briefly discuss some important treatment considerations. Thus, this review is intended to offer clinicians and pathologists an overview of primary gastrointestinal lymphomas.
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Affiliation(s)
- Brendan C Dickson
- University of Toronto, Department of Laboratory Medicine and Pathobiology, Toronto General Hospital, Department of Pathology, 200 Elizabeth Street, 11th Floor, Residents and Fellows Room, Toronto, Ontario, Canada.
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Matsuo S, Mizuta Y, Hayashi T, Susumu S, Tsutsumi R, Azuma T, Yamaguchi S. Mucosa-associated lymphoid tissue lymphoma of the transverse colon: A case report. World J Gastroenterol 2006; 12:5573-6. [PMID: 17007004 PMCID: PMC4088249 DOI: 10.3748/wjg.v12.i34.5573] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We herein present a case of a 75-year-old female with mucosa-associated lymphoid tissue (MALT) lymphoma of the transverse colon with the stage IE (Ann Arbor classification). Colonoscopy revealed the tumor’s appearance as a IIa plus IIc-like early colon cancer as defined according to the macroscopic classification of the Japanese Research Society for Cancer of Colon, Rectum and Anus, measuring less than 2 cm in diameter. Histologically, the tumor was diagnosed as MALT lymphoma because of the presence of lymphoepithelial lesions consisting of diffuse proliferation of atypical lymphocytes and glandular destruction. The majority of these lymphocytes immunohistochemically stained for the B-lymphocyte marker. The patient first underwent H pylori eradication therapy with Lansap®. However, the tumor size gradually increased over the next 4 mo and the patient eventually underwent surgical resection. The operative procedure included a partial colectomy with dissection of the paracolic lymph nodes. The tumor measured 45 mm x 30 mm in diameter and histological examination showed that the lymphoma cells had infiltrated the muscle layer of the colon without nodal involvement. The patient has had no recurrence postoperatively without any chemotherapy.
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MESH Headings
- Aged
- Anti-Bacterial Agents/therapeutic use
- Colon, Transverse/microbiology
- Colon, Transverse/pathology
- Colon, Transverse/surgery
- Colonic Neoplasms/microbiology
- Colonic Neoplasms/pathology
- Colonic Neoplasms/surgery
- Disease Progression
- Drug Resistance, Microbial
- Female
- Helicobacter Infections/complications
- Helicobacter Infections/drug therapy
- Helicobacter pylori
- Humans
- Lymphoma, B-Cell, Marginal Zone/microbiology
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/surgery
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Affiliation(s)
- Shigetoshi Matsuo
- Department of Surgery, Nagasaki Prefectural Shimabara Hospital, 7895 Shimokawajiri, Shimabara, Nagasaki 855-0861, Japan.
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Ochi M, Tominaga K, Okazaki H, Yamamori K, Wada T, Shiba M, Sasaki E, Watanabe T, Fujiwara Y, Oshitani N, Higuchi K, Arakawa T. Regression of primary low-grade mucosa-associated lymphoid tissue lymphoma of duodenum after long-term treatment with clarithromycin. Scand J Gastroenterol 2006; 41:365-9. [PMID: 16497629 DOI: 10.1080/00365520500331224] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A 74-year-old woman was referred to our department because of epigastralgia. Endoscopic findings revealed yellowish bumpy mucosa from the bulbus to the second portion of the duodenum. The patient was admitted to our hospital for further examinations and treatment for this lesion. Endoscopic mucosal resection (EMR) was performed on part of the lesion to obtain the final diagnosis, and then mucosa-associated lymphoid tissue (MALT) lymphoma of the duodenum was diagnosed using this procedure. In this case, no evidence of Helicobacter pylori infection in the patient's stomach was detected by any of the diagnostic examinations used, such as the urea breath test, histological study, culture, and serological antibody. For this reason, the patient's duodenal MALT lymphoma was treated solely with long-term clarithromycin, which had an inhibitory action on lymphocyte activation. The lesion showed slight improved during the first 12 days of treatment, and complete regression was reached after 6 months of treatment. It is suggested that the long-term use of clarithromycin may be effective for diseases of the gastrointestinal tract associated with the lymphocyte proliferation.
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Affiliation(s)
- Masahiro Ochi
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.
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Hoption Cann SA, van Netten JP, van Netten C. Acute infections as a means of cancer prevention: opposing effects to chronic infections? ACTA ACUST UNITED AC 2006; 30:83-93. [PMID: 16490323 DOI: 10.1016/j.cdp.2005.11.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2005] [Indexed: 01/28/2023]
Abstract
PURPOSE Epidemiological studies have found an inverse association between acute infections and cancer development. In this paper, we review the evidence examining this potentially antagonistic relationship. METHODS In addition to a review of the historical literature, we examined the recent epidemiological evidence on the relationship between acute infections and subsequent cancer development in adult life. We also discuss the impact of chronic infections on tumor development and the influence of the immune system in this process. RESULTS Exposures to febrile infectious childhood diseases were associated with subsequently reduced risks for melanoma, ovary, and multiple cancers combined, significant in the latter two groups. Epidemiological studies on common acute infections in adults and subsequent cancer development found these infections to be associated with reduced risks for meningioma, glioma, melanoma and multiple cancers combined, significantly for the latter three groups. Overall, risk reduction increased with the frequency of infections, with febrile infections affording the greatest protection. In contrast to acute infections, chronic infections can be viewed as resulting from a failed immune response and an increasing number have been associated with an elevated cancer risk. CONCLUSION Infections may play a paradoxical role in cancer development with chronic infections often being tumorigenic and acute infections being antagonistic to cancer.
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Affiliation(s)
- Stephen A Hoption Cann
- Department of Health Care and Epidemiology, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, Canada V6T 1Z3.
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37
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Kikuchi Y, Matsui T, Hisabe T, Wada Y, Hoashi T, Tsuda S, Yao T, Iwashita A, Imamura K. Deep infiltrative low-grade MALT (mucosal-associated lymphoid tissue) colonic lymphomas that regressed as a result of antibiotic administration: endoscopic ultrasound evaluation. J Gastroenterol 2005; 40:843-7. [PMID: 16143891 DOI: 10.1007/s00535-005-1639-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2004] [Accepted: 02/25/2005] [Indexed: 02/04/2023]
Abstract
Since 1997 we have experienced three cases of low-grade colonic mucosal-associated lymphoid tissue (MALT) lymphomas. The depth of tumor invasion was evaluated by endoscopic ultrasonography (EUS) and the mass lesions were all diagnosed as having extended beyond the deep region of the submucosal layer. Although all of these patients tested negative for gastric Helicobacter pylori, their tumor lesions regressed after antibiotic treatment in accordance with H. pylori eradication therapy. In general, consensus has been reached regarding antibiotic therapy for gastric MALT lymphomas. However, as a prerequisite for antibiotic therapy, the therapy has been deemed effective against these gastric tumors if the extent of infiltration, as evaluated by EUS, is limited to the mucosal layer or the superficial region of the submucosal layer. Based on the therapeutic outcomes seen in the three patients studied here, it is suggested that antibiotic therapy might be useful in treating MALT lymphomas of the colon, even in patients with advanced invasive tumors, in contrast to the extent of the lesions in the stomach suitable for antibiotic treatment. The success of the antibiotic treatment also suggests that MALT lymphomas may be caused by unknown luminal microorganisms, other than H. pylori.
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Affiliation(s)
- Yosuke Kikuchi
- Department of Gastroenterology, Fukuoka University Chikushi Hospital, 377-1 Ohaza Zokumyoin, Chikushino, 818-5807, Japan
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Guardiola H, Pérez Muñoz N. [Abdominal pain and rectorrhage in a 68-year-old woman]. Med Clin (Barc) 2005; 124:588-94. [PMID: 15860175 DOI: 10.1157/13074143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
MESH Headings
- Abdominal Pain/complications
- Abdominal Pain/diagnosis
- Aged
- Angiography
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Murine-Derived
- Antigens, CD20/immunology
- Antineoplastic Agents/therapeutic use
- Arteriovenous Malformations/diagnostic imaging
- Diagnosis, Differential
- Female
- Hemorrhage/complications
- Hemorrhage/diagnosis
- Humans
- Lymphoma, B-Cell, Marginal Zone/drug therapy
- Lymphoma, B-Cell, Marginal Zone/immunology
- Lymphoma, B-Cell, Marginal Zone/pathology
- Mesenteric Artery, Superior/abnormalities
- Mesenteric Artery, Superior/diagnostic imaging
- Phenotype
- Rectal Diseases/complications
- Rectal Diseases/diagnosis
- Rituximab
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Affiliation(s)
- Helena Guardiola
- Servicio de Medicina Interna, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona
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39
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Yamamoto R, Kato S, Shimazaki K, Yoshizumi T, Uefuji K, Seo M, Matsuura T, Kikuchi M, Itoh K, Miura S. A case of primary rectal mucosa-associated lymphoid tissue lymphoma treated by endoscopic mucosal resection. Dig Endosc 2005. [DOI: 10.1111/j.1443-1661.2005.00487.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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40
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Narváez JA, Domingo-Domènech E, Roca Y, Romagosa V, De Lama E, González-Barca E, Petit J, Fernández-Sevilla A. Radiological features of non-gastric mucosa-associated lymphoid tissue lymphomas. Curr Probl Diagn Radiol 2005; 33:212-25. [PMID: 15459631 DOI: 10.1067/j.cpradiol.2004.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- José Antonio Narváez
- Department of CT and MR Imaging, Institut de Diagnòstic per la Imatge,Hospital Duran i Reynals, Barcelona, Spain
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41
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Fu KI, Yagi S, Mashimo Y, Sugitani K, Imamaki K, Yanagisawa M, Maekawa S, Morimoto Y, Fujimori T. Regression of Helicobacter pylori-negative duodenal ulcers complicated by Schonlein-Henoch purpura with H. pylori eradication therapy: the first report. Dig Dis Sci 2005; 50:381-4. [PMID: 15745104 DOI: 10.1007/s10620-005-1614-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Kuang-I Fu
- Ogawa Red Cross Hospital, 1525, Ogawa, Ogawa-machi, Hiki, Saitama 355-0397, Japan.
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42
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Gastrointestinal Lymphoma. Mucosal Immunol 2005. [DOI: 10.1016/b978-012491543-5/50081-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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43
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Hori K, Suguro M, Koizuka H, Sakagami T, Tomita T, Kosaka T, Fukuda Y. Disappearance of rectal mucosa-associated lymphoid tissue lymphoma following antibiotic therapy. Dig Dis Sci 2004; 49:413-6. [PMID: 15139490 DOI: 10.1023/b:ddas.0000020495.83052.74] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Kazutoshi Hori
- Department of Gastroenterology, Hyogo College of Medicine, Nishinomiya, Japan.
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44
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Hirasaki S, Endo H, Nishina T, Masumoto T, Tanimizu M, Hyodo I, Tajiri H. Mucosa-associated lymphoid tissue lymphoma occurring in the transverse colon. Dig Endosc 2003. [DOI: 10.1046/j.1443-1661.2003.00250.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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45
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Tanaka S, Ohta T, Kaji E, Kosaka T, Murakami I. EMR of mucosa-associated lymphoid tissue lymphoma of the rectum. Gastrointest Endosc 2003; 57:956-9. [PMID: 12776055 DOI: 10.1016/s0016-5107(03)70039-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Shouichi Tanaka
- Department of Gastroenterology, Iwakuni National Hospital, Iwakuni, Japan
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46
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Thieblemont C, de la Fouchardière A, Coiffier B. Nongastric mucosa-associated lymphoid tissue lymphomas. CLINICAL LYMPHOMA 2003; 3:212-24. [PMID: 12672270 DOI: 10.3816/clm.2003.n.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Nongastric mucosa-associated lymphoid tissue (MALT)-derived lymphomas arise from various extranodal locations and are usually related to a particular pathogenesis with a possible external (environmental or autoimmune) event inducing the disease. We reviewed 165 patients with nongastric MALT lymphoma among the 243 patients with MALT lymphoma in our database and reviewed reports in the literature to analyze the clinical features of nongastric MALT lymphomas. The site of clinical presentation was related to the lymphoma location and was usually indolent. Dissemination of the disease at diagnosis was noticed in 48% of cases because of the involvement of multiple mucosal sites (48%) or because of a nonmucosal site involvement such as bone marrow, spleen, or liver (52%). With a median follow-up of 4 years, the estimated 5-year overall survival and 5-year freedom-from-progression rates were 89% and 50%, respectively, without any difference between patients with localized or disseminated disease or among different locations. Treatment recommendations for localized disease are based on surgery, local therapy, or chlorambucil. For disseminated disease, treatment recommendations include chemotherapy with fludarabine or chlorambucil or chemotherapy with CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone) in cases of large tumor mass
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Affiliation(s)
- Catherine Thieblemont
- Hematology Department, Hospices Civils de Lyon, Université Claude Bernard, Lyon, France
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47
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OKADA HIROYUKI, MIZUNO MOTOWO, YOSHINO TADASHI, YOKOTA KENJI, OKAZAKI HIROAKI, OKANO NOBUAKI, NASU JUNICHIROU, MANNAMI TOMOHIKO, OGUMA KEIJI, AKAGI TADAATSU, TSUJI TAKAO, SHIRATORI YASUSHI. CONCURRENT GASTRIC AND COLONIC LOW‐GRADE MUCOSA‐ASSOCIATED LYMPHOID TISSUE LYMPHOMATA IN A PATIENT WITHOUT HELICOBACTER PYLORIINFECTION. Dig Endosc 2003. [DOI: 10.1046/j.1443-1661.2003.00108.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- HIROYUKI OKADA
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - MOTOWO MIZUNO
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - TADASHI YOSHINO
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - KENJI YOKOTA
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - HIROAKI OKAZAKI
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - NOBUAKI OKANO
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - JUNICHIROU NASU
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - TOMOHIKO MANNAMI
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - KEIJI OGUMA
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - TADAATSU AKAGI
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - TAKAO TSUJI
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
| | - YASUSHI SHIRATORI
- Departments of * Medicine and Medical Science, † Pathology and Pathobiology, and ‡ Bacteriology, Okayama University Graduate School of Medicine and Dentristry, Okayama City, Japan
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