Regression of high-grade gastric B-cell lymphoma after eradication of Helicobacter pylori with antibiotic therapy has recently been shown in a very small number of patients. We describe here a patient with a 5-cm polypoid gastric lymphoma, who received a 7-day course of triple therapy when the histopathology was unknown. A second endoscopic examination 4 weeks later showed partial tumor regression without biopsy evidence of malignancy. Endoscopic mucosectomy was performed 8 weeks after the initial diagnosis. Again, in the histological analysis of the specimen, no evidence of B-cell lymphoma could be found. To confirm that the original biopsies were from the same patient, DNA analyses were carried out which gave identical results. This case suggests that a subgroup of primary gastric B-cell lymphomas responds to eradication of H. pylori with antibiotic therapy.
References
-
1
Connors J, Wise L.
Management of gastric lymphoma.
Am J Surg.
1974;
127
102-108
-
2
Isaacson P G, Spencer J.
Malignant lymphoma of mucosa-associated lymphoid tissue.
Histopathology.
1987;
11
445-462
-
3
Wyatt J I, Rathbone B J.
Immune response of the gastric mucosa to Campylobacter pylori.
Scand J Gastroenterol.
1988;
23
44-49
-
4
Stolte M, Eidt S.
Lymphoid follicles in the antral mucosa: immune response to Campylobacter pylori.
J Clin Pathol.
1989;
42
1269-1271
-
5
Isaacson P G, Wotherspoon A C, Diss T, Pan L.
Follicular colonization in B-cell lymphoma of mucosa-associated lymphoid tissue.
Am J Surg Pathol.
1991;
15
819-828
-
6
Wotherspoon A C, Doglioni C, Diss T C, et al.
Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradication of Helicobacter pylori.
Lancet.
1993;
342
575-577
-
7
Hussel T, Isaacson P G, Crabtree J, Spencer J.
The response of cells from low-grade B-cell gastric lymphomas of mucosa-associated lymphoid tissue to Helicobacter pylori.
Lancet.
1993;
342
571-574
-
8
Inoue S, Matsumoto T, Linda M, et al.
Regression of gastric lymphoma of mucosa-associated lymphoid tissue by Helicobacter pylori eradication: endoscopic observation.
Gastrointest Endosc.
1997;
46
377-379
-
9
Thied C, Morgner A, Alpen B, et al.
What role does Helicobacter pylori eradication play in gastric MALT and gastric MALT lymphoma?.
Gastroenterology.
1997;
113
61-64
-
10
Boot H, de Jong D, van Heerde P, Taal B.
Role of Helicobacter pylori eradication in high-grade MALT lymphoma.
Lancet.
1995;
346
448-449
-
11
Wai-Wah N G, Lam C -P, Chau W -K, et al.
Regression of high-grade gastric mucosa associated lymphoid tissue lymphoma with Helicobacter pylori after triple antibiotic therapy.
Gastrointest Endosc.
2000;
51
93-96
-
12
Bayerdörffer E, Neubauer A, Burkhard R, et al. for MALT Lymphoma Study Group.
Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure of Helicobacter pylori infection.
Lancet.
1995;
345
1591-1594
-
13
Rudolph B, Bayerdörffer E, Ritter M, et al.
Is the polymerase chain reaction or cure of Helicobacter pylori infection of help in the differential diagnosis of early gastric mucosa-associated lymphatic tissue lymphoma?.
J Clin Oncol.
1997;
15
1104-1109
-
14
Kolve M E, Greiner A, Müller-Hermelink K -H, et al. for Gastrointestinal Lymphoma Study Group.
Eradication of Helicobacter pylori (Hp) in gastric malt type lymphoma in still an experimental therapy.
Gastroenterology.
1997;
112
594
-
15
Grifford R RM, Ferguson R, Voss B V.
Cimetidine reduction of tumor formation in mice.
Lancet.
1981;
1
638-639
-
16
Ogawa D, Uemura N, Sasaki N, et al.
Spontaneous regression of malignant lymphoma of the stomach.
J Med.
1998;
29
381-393
-
17
Furusyo N, Kanamoto K, Shotaro N, et al.
Rapidly growing primary gastric B-cell lymphoma after eradication of Helicobacter pylori.
Int Med.
1999;
38
796-799
P. M. Schlag
Universitätsklinikum Charité
Med. Fakultät der Humboldt-Universität zu Berlin
Robert-Rössle-Klinik
Lindenberger Weg 80
13122 Berlin
Fax: + 49-30-94171404
Email: Schlag@rrk-berlin.de