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Journal of Gastroenterology

, Volume 32, Issue 4, pp 543–547 | Cite as

Regression of atypical lymphoid hyperplasia after eradication ofHelicobacter pylori

  • Toshihito Tanahashi
  • Yoshihide Tatsumi
  • Naoki Sawai
  • Yoshio Yamaoka
  • Makoto Nakajima
  • Tadashi Kodama
  • Kei Kashima
Case Report

Abstract

A rare case of endescopic and histological regression of a gastric lymphoid mucosal lesion after eradication ofHelicobacter pylori is reported. A 72-year-old man was suspected of having a low-grade B-cell gastric mucosa-associated lymphoid tissue (MALT) lymphoma by endoscopic and histological findings. Histology of biopsy specimens showed massive infiltration of atypical lymphocytes and lymphoepithelial lesions. Immunohistochemical staining revealed kappa light chain expression in the infiltrated atypical lymphocytes to be twofold that of lambda light chain. The above diagnosis was thus highly suspected but not confirmed. Antibiotic therapy was given on the basis of evidence ofH. pylori infection. Successful eradication ofH. pylori resulted in remarkable improvement of endoscopic and histological findings. Follow-up studies were carried out 8 months after eradication, with no evidence of relapse. The eradication ofH. pylori appears to be an effective alternative therapy for B-cell lymphoproliferative disease, although longer follow-up and further studies are needed before this treatment can be establisted.

Key words

Helicobacter pylori atypical lymphoid hyperplasia primary gastric MALT lymphoma 

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References

  1. 1.
    Isaacson PG, Wright DH. Malignant lymphoma of mucosa-associated lymphoid tissue, a distinctive type of B-cell lymphoma. Cancer 1983;52:1410–1416.PubMedCrossRefGoogle Scholar
  2. 2.
    Isaacson PG, Wright DH. Extranodal malignant lymphoma arising from mucosa-associated lymphoid tissue. Cancer 1984;53:2515–2524.PubMedCrossRefGoogle Scholar
  3. 3.
    Isaacson PG, Spencer J. Malignant lymphoma of mucosa-associated lymphoid tissue. Histopathology 1987;11:445–462.PubMedCrossRefGoogle Scholar
  4. 4.
    Wotherspoon AC, Ortiz-Hidalgo C, Isaacson PG.Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma. Lancet 1991;338:1175–1176.PubMedCrossRefGoogle Scholar
  5. 5.
    Hussel T, Isaacson PG, Crabtree JE, Spencer J. The response of cells from low-grade B-cell gastric lymphomas of mucosa-associated lymphoid tissue toHelicobacter pylori. Lancet 1993;342:571–574.CrossRefGoogle Scholar
  6. 6.
    Stolte M.Helicobacter pylori gastritis and gastric MALT-lymphoma. Lancet 1992;339:745–746.PubMedCrossRefGoogle Scholar
  7. 7.
    Wotherspoon AC, Doglioni C, Isaacson PG. Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradication ofHelicobacter pylori. Lancet 1993;342:575–577.PubMedCrossRefGoogle Scholar
  8. 8.
    Wotherspoon AC, Doglioni C, Isaacson PG. Antibiotic reatment for low-grade gastric MALT lymphoma. Lancet 1994; 343:1503.PubMedCrossRefGoogle Scholar
  9. 9.
    Stolte M, Eidt S. Healing gastric MALT lymphomas by eradicatingH. pylori? Lancet 1993;342:568.PubMedCrossRefGoogle Scholar
  10. 10.
    Bayerdorffer E, Neubauer A, Rudolph B, et al. for MALT Lymphoma Study Group. Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure ofHelicobacter pylori infection. Lancet 1995;345:1591–1594.PubMedCrossRefGoogle Scholar
  11. 11.
    Coglatti SB, Schmid U, Takahashi H. Primary B cell gastric lymphoma: A clinicopathological study of 145 patients. Gastroenterology 1991;101:1159–1170.Google Scholar
  12. 12.
    Takano Y, Kato Y, Sugano H. Histopathological and immunohistochemical study of atypical lymphoid hyperplasia and benign lymphoid hyperplasia of the stomach. Jpn J Cancer Res 1992;83:288–293.PubMedGoogle Scholar
  13. 13.
    Takano Y, Kato Y, Okayasu I. Where should ordinary RLH be placed in relation to ALh, BLH, and gastric MALT lymphoma (in Japanese with English abstract). Endosc Dig 1995;7:1479–1487.Google Scholar
  14. 14.
    Horstmann M, Erttmann R, Winkler K. Relapse, of MALT lymphoma associated withHelicobacter pylori after antibiotic treatment. Lancet 1994;343:1098–1099.PubMedCrossRefGoogle Scholar
  15. 15.
    Cammarota G, Montalto M, Tursi A, et al.Helicobacter pylori infection and rapid relapse of low-grade B-cell gastric lymphoma. Lancet 1995;345:192.PubMedCrossRefGoogle Scholar
  16. 16.
    Karita M, Li Q, Okita K. Evaluation of new triple therapy for eradication ofH. pylori infection in nude mouse model. Am J Gastroenterol 1993;88:1366–1372.PubMedGoogle Scholar
  17. 17.
    Fukuda Y, Yamamoto Y, Okui M., et al. Combination therapies with proton pump inhibitor forHelicobacter pylori infected gastric ulcer patients. J Clin Gastroenterol 1995;20(Suppl 2):S132–135.CrossRefGoogle Scholar
  18. 18.
    Ono H, et al. Clinicopathological changes of gastric MALT lymphomas with or without eradication ofHelicobacter pylori (in Japanese with English abstract). Stomach Intestine 1996;1:83–92.Google Scholar

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • Toshihito Tanahashi
    • 1
  • Yoshihide Tatsumi
    • 1
  • Naoki Sawai
    • 1
  • Yoshio Yamaoka
    • 1
  • Makoto Nakajima
    • 1
  • Tadashi Kodama
    • 1
  • Kei Kashima
    • 1
  1. 1.Third Department of Internal MedicineKyoto Prefectural University of MedicineKyotoJapan

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