Advertisement

The gastric lymphomas and the role of Helicobacter pylori in tumour development: have criteria been set for diagnosis?

  • M. F. Dixon

Abstract

Gastric lymphomas account for only a small proportion of gastric malignancies, between 1% and 7% depending on the geographical area1, but their incidence is increasing2. Almost all are B-cell lymphomas, a proportion of which recapitulate the appearances of mucosa-associated lymphoid tissue (MALT) and are similar to low-grade B-cell lymphomas arising in the lung, thyroid and salivary gland3. As with these latter two sites, the stomach has no intrinsic lymphoid tissue. It is now clear that the appearance of a lymphoid infiltrate in the gastric mucosa is largely a consequence of H. pylori infection. Thus it can be anticipated that H. pylori gastritis is a major precursor of gastric lymphoma, and evidence to this effect has accumulated over recent years.

Keywords

Pylorus Infection Chronic Gastritis Mucosa Associate Lymphoid Tissue Follicular Dendritic Cell Marginal Zone Lymphoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Cogliatti SB, Schmid U, Schumacher FE et al. Primary B-cell gastric lymphoma: a clinicopathological study of 145 patients. Gastroenterology. 1991;101:1159–70.PubMedGoogle Scholar
  2. 2.
    Severson RK, Davis S. Increasing incidence of primary gastric lymphoma. Cancer. 1990;66: 1283–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Isaacson PG. Lymphomas of mucosa-associated lymphoid tissue (MALT). Histopathology. 1990; 16:617–19.PubMedCrossRefGoogle Scholar
  4. 4.
    Parsonnet J, Hansen S, Rodriguez L et al. Helicobacter pylori and gastric lymphoma. N Engl J Med. 1994;330:1267–71.PubMedCrossRefGoogle Scholar
  5. 5.
    Wotherspoon AC, Doglioni C, Diss TC et al. Regression of primary low-grade B-cell gastric lymphoma of mucosa associated lymphoid tissue after eradication of Helicobacter pylori. Lancet. 1993;342:575–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Crabtree J. Gastric mucosal inflammatory responses to Helicobacter pylori. Aliment Pharmacol Ther. 1996;10(Suppl. 1):29–37.PubMedGoogle Scholar
  7. 7.
    Yoshida N, Granger DN, Evans DJ et al. Mechanisms involved in Helicobacter pylori-induced inflammation. Gastroenterology. 1993; 105:1431–40.PubMedCrossRefGoogle Scholar
  8. 8.
    Clark EA, Ledbetter JA. How B and T cells talk to each other. Nature. 1994;367:425–8.CrossRefGoogle Scholar
  9. 9.
    Enno A, O’Rourke JL, Howlett CR, Jack A, Dixon MF, Lee A. MALT-oma-like lesions in the murine gastric mucosa after long-term infection with Helicobacter felis. A mouse model of Helicobacter pylori-induced gastric lymphoma. Am J Pathol. 1995;147:217–22.PubMedGoogle Scholar
  10. 10.
    Genta RM, Hamner HW, Graham DY. Gastric lymphoid follicles in Helicobacter pylori infection: frequency, distribution, and response to triple therapy. Hum Pathol. 1993;24:577–83.PubMedCrossRefGoogle Scholar
  11. 11.
    Miehlke S, Lehn N, Bayerdörffer E, Meining A, Graham DY, Go MF. Are specific vacA subtypes of Helicobacter pylori associated with primary gastric lymphoma? Gastroenterology. 1996; 110: A196.Google Scholar
  12. 12.
    Isaacson PG. Gastrointestinal lymphomas and lymphoid hyperplasias. In: Knowles DM, editor. Neoplastic haematopathology. Baltimore: Williams & Wilkins; 1992:953–78.Google Scholar
  13. 13.
    Isaacson PG, Norton AJ. Extranodal lymphomas. London: Churchill Livingstone; 1994:5–14.Google Scholar
  14. 14.
    Lydyard P, Grossi C. Secondary lymphoid organs and tissues. In: Roitt I, Brostoff J, Male D, editors. Immunology, 4th edn. London: Mosby; 1996:3.1–3.11.Google Scholar
  15. 15.
    Quiding-Järbrink M, Lakew M, Norström I et al. Human circulating specific antibody-forming cells after systemic and mucosal immunizations: differential homing commitments and cell surface differentiation markers. Eur J Immunol. 1995;25:322–7.PubMedCrossRefGoogle Scholar
  16. 16.
    Newell DG, Stacey AR. Isotype and specificity of local and systemic anti-Helicobacter pylori antibodies. In: Menge H, Gregor M, Tytgat GNJ et al., editors. Helicobacter pylori. Berlin: Springer-Verlag; 1991:83–9.Google Scholar
  17. 17.
    Patel P, Mendall MA, Khulusi S et al. Salivary antibodies to Helicobacter pylori: screening dyspeptic patients before endoscopy. Lancet. 1994;344:511–12.PubMedCrossRefGoogle Scholar
  18. 18.
    Hussell T, Isaacson PG, Crabtree JE, Spencer J. The response of cells from low-grade B-cell gastric lymphomas of mucosa associated lymphoid tissue to Helicobacter pylori. Lancet. 1993; 342:571–4.PubMedCrossRefGoogle Scholar
  19. 19.
    Hussell T, Isaacson PG, Crabtree JE, Spencer J. Helicobacter pylori specific tumour infiltrating T cells provide contact dependent help for the growth of malignant B cells in low grade gastric lymphoma of mucosa associated lymphoid tissue. J Pathol. 1996;178:122–7.PubMedCrossRefGoogle Scholar
  20. 20.
    Spencer J, Diss TC, Isaacson PG. A study of the properties of a low-grade mucosal B-cell lymphoma using a monoclonal antibody specific for the tumour immunoglobulin. J Pathol. 1990; 160:231–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Greiner A, Marx A, Heesemann J, Leebmann J, Schmausser B, Muller-Hermelink HK. Idiotype identity in a MALT-type lymphoma and B cells in Helicobacter prylori-associated chronic gastritis. Lab Invest. 1994;70:572–8.PubMedGoogle Scholar
  22. 22.
    Greiner A, Marx A, Schmausser B, Muller-Hermelink HK. The pivotal role of the immunoglobulin receptor of tumor cells from B cell lymphomas of mucosa associated lymphoid tissue (MALT). Adv Exp Med Biol. 1994;355:189–93.PubMedGoogle Scholar
  23. 23.
    Crabtree JE, Spencer J. Immunologic aspects of Helicobacter pylori infection and malignant transformation of B cells. Sem Gastrointest Dis. 1996;7:30–40.Google Scholar
  24. 24.
    Wotherspoon AC, Finn TM, Isaacson PG. Trisomy 3 in low grade B cell lymphomas of mucosa associated lymphoid tissue (MALT). Blood. 1995;85:2000–4.PubMedGoogle Scholar
  25. 25.
    Ye BH, Rao PH, Chaganti RSK, Dalla-Favera R. Cloning of bcl-6, the locus involved in chromosome translocations affecting band 3q27 in B-cell lymphoma. Cancer Res. 1993;53:2732–5.PubMedGoogle Scholar
  26. 26.
    Pan L, Diss TC, Cunningham D, Isaacson PG. The bcl-2 gene in primary B cell lymphoma of mucosa-associated lymphoid tissue (MALT). Am J Pathol. 1989;135:7–11.PubMedGoogle Scholar
  27. 27.
    Nakamura S, Akazawa K, Kinukawa N, Yao T, Tsuneyoshi M. Inverse correlation between the expression of bcl-2 and p53 proteins in primary gastric lymphoma. Hum Pathol. 1996;27:225–33.PubMedCrossRefGoogle Scholar
  28. 28.
    Wotherspoon AC, Pan L, Diss TC, Isaacson PG. Cytogenetic study of B-cell lymphoma of mucosa-associated lymphoid tissue. Cancer Genet Cytogenet. 1992;58:35–8.PubMedCrossRefGoogle Scholar
  29. 29.
    Horsman D, Gascoyne R, Klasa R, Coupland R. t(11;18) (q21;q21.1): a recurring translocation in lymphomas of mucosa-associated lymphoid tissue (MALT). Genes Chromosom Cancer. 1992; 4:183–6.PubMedCrossRefGoogle Scholar
  30. 30.
    Peng HZ, Diss TC, Isaacson PG, Pan LX. C-myc gene abnormalities in lymphomas arising in mucosa-associated lymphoid tissue (MALT). Lab Invest. 1996;74:120A.Google Scholar
  31. 31.
    Calvert R, Randerson J, Evans P et al. Genetic abnormalities during transition from Helicobacter pylori-associated gastritis to low-grade MALToma. Lancet. 1995;345:26–7.PubMedCrossRefGoogle Scholar
  32. 32.
    Peng H, Chen G, Du M, Singh N, Isaacson PG, Pan L. Replication error phenotype and p53 gene mutation in lymphomas of mucosa-associated lymphoid tissue. Am J Pathol. 1996;148:643–8.PubMedGoogle Scholar
  33. 33.
    Gleeson CM, Sloan JM, McGuigan JA, Ritchie AJ, Weber JL, Russell SEH. Ubiquitous somatic alterations at microsatellite alleles occur infrequently in Barrett’s-associated esophageal adenocarcinoma. Cancer Res. 1996;56:259–63.PubMedGoogle Scholar
  34. 34.
    Gleeson CM, Sloan JM, McGuigan JA, Ritchie AJ, Weber JL, Russell SEH. Ubiquitous somatic alterations at microsatellite alleles occur infrequently in adenocarcinoma of the oesophagus and gastric cardia. Gut. 1996;38(Suppl. 1):A32.Google Scholar
  35. 35.
    Bronner MP, Crispin DA, Hueffed R et al. Microsatellite instability in non-neoplastic gastrointestinal disorders. Lab Invest. 1996;74:55A.Google Scholar
  36. 36.
    Nizze H, Cogliatti SB, von Schilling C et al. Monocytoid B-cell lymphoma: morphological subtypes and relationship to the low-grade B-cell lymphoma of the mucosa associated lymphoid tissue. Histopathology. 1991;18:403–14.PubMedCrossRefGoogle Scholar
  37. 37.
    Wotherspoon AC, Doglioni C, Isaacson PG. Low-grade gastric B-cell lymphoma of mucosa-associated lymphoid tissue (MALT): a multifocal disease. Histopathology. 1992;20:29–34.PubMedCrossRefGoogle Scholar
  38. 38.
    Anton RC, Steinbach G, Pugh W et al. Primary gastric lymphomas: strong correlation with Helicobacter pylori infection and atrophic gastritis. Lab Invest 1996;74:54A.Google Scholar
  39. 39.
    Papadaki L, Wotherspoon AC, Isaacson PG. The lymphoepithelial lesion of gastric low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT): an ultrastructural study. Histopathology. 1992;21:415–21.PubMedCrossRefGoogle Scholar
  40. 40.
    Eidt S, Stolte M, Fischer R. Helicobacter pylori gastritis and primary gastric non-Hodgkin’s lymphomas. J Clin Pathol. 1994;457:436–9.CrossRefGoogle Scholar
  41. 41.
    Isaacson PG, Wotherspoon AC, Diss T, Pan L. Follicular colonization in B-cell lymphoma of mucosa-associated lymphoid tissue. Am J Surg Pathol. 1991;15:819–28.PubMedCrossRefGoogle Scholar
  42. 42.
    Zuckerberg LR, Ferry JA, Southern JF, Harris NL. Lymphoid infiltrates of the stomach. Evaluation of histologic criteria for the diagnosis of low-grade gastric lymphoma on endoscopic biopsy specimens. Am J Surg Pathol. 1990;14:1087–99.CrossRefGoogle Scholar
  43. 43.
    Arista-Nasr J, Jimenez A, Keirns C, Larraza O, Larriva-Sahd J. The role of endoscopic biopsy in the diagnosis of gastric lymphoma. Hum Pathol. 1991;22:339–48.PubMedCrossRefGoogle Scholar
  44. 44.
    Spencer J, Diss TC, Isaacson PG. Primary B cell gastric lymphoma. A genotypic analysis. Am J Pathol. 1989;135:557–64.PubMedGoogle Scholar
  45. 45.
    Williams GT, Wynford-Thomas D. How may clonality be assessed in human tumours? Histopathology. 1994;24:287–92.PubMedCrossRefGoogle Scholar
  46. 46.
    Algara P, Martinez P, Sanchez L et al. The detection of monoclonal B-cell populations by polymerase chain reaction: accuracy of approach and application in gastric endoscopic biopsy specimens. Hum Pathol. 1993;24:1184–8.PubMedCrossRefGoogle Scholar
  47. 47.
    Diss TC, Pan L, Peng H et al. Sources of DNA for detecting B cell monoclonality using PCR. J Clin Pathol. 1994;47:493–6.PubMedCrossRefGoogle Scholar
  48. 48.
    Fend F, Schwaiger A, Weyrer K et al. Early diagnosis of gastric lymphoma: gene rearrangement analysis of endoscopic biopsy samples. Leukemia. 1994;8:35–9.PubMedGoogle Scholar
  49. 49.
    Inagaki H, Nonaka M, Nagaya S, Tateyama H, Sasaki M, Eimoto T. Monoclonality in gastric lymphoma detected in formalin-fixed, paraffin-embedded endoscopic biopsy specimens using immunohistochemistry, in situ hybridization, and polymerase chain reaction. Diag Molec Pathol. 1995;4:32–8.CrossRefGoogle Scholar
  50. 50.
    Savio A, Franzin G, Wotherspoon AC et al. Diagnosis and posttreatment follow-up of Helicobacter pylori-positive gastric lymphoma of mucosa-associated lymphoid tissue: histology, polymerase chain reaction or both? Blood. 1996;87:1255–60.PubMedGoogle Scholar
  51. 51.
    Calvert RJ, Evans PAS, Randerson JA et al. The significance of B-cell clonality in gastric lymphoid infiltrates. J Pathol. 1996 (In press).Google Scholar
  52. 52.
    Hsi ED, Greenson JK, Singleton TP, Siddiqui J, Schnitzer B, Ross CW. Detection of immunoglobulin heavy chain gene rearrangement by polymerase chain reaction in chronic active gastritis associated with Helicobacter pylori. Hum Pathol. 1996;27:290–6.PubMedCrossRefGoogle Scholar
  53. 53.
    Banerjee SK, Weston AP, Horvat RT, Campbell DR, Cherian R, Makdisi WF. Determination of specificity of PCR monoclonality for the diagnosis of gastric lymphoma: direct comparison to Southern blot gene rearrangement. Gastroenterology. 1996;110:A487.CrossRefGoogle Scholar
  54. 54.
    Chan JKC, Ng CS, Isaacson PG. Relationship between high grade lymphoma and low-grade B-cell mucosa-associated lymphoid tissue lymphoma (MALToma) of the stomach. Am J Pathol. 1990;136:1153–64.PubMedGoogle Scholar
  55. 55.
    Eidt S, Stolte M, Fischer R. Factors influencing lymph node infiltration in primary gastric malignant lymphoma of the mucosa-associated lymphoid tissue. Pathol Res Prac. 1994; 190: 1077–81.Google Scholar
  56. 56.
    Wotherspoon AC, Ortiz-Hidalgo C, Falzon MR, Isaacson PG. Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma. Lancet. 1991;338:1175–6.PubMedCrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers and Axcan Pharma 1996

Authors and Affiliations

  • M. F. Dixon

There are no affiliations available

Personalised recommendations