Regression of gastric high grade mucosa associated lymphoid tissue (MALT) lymphoma after Helicobacter pylori eradication
Regression of gastric high grade mucosa associated lymphoid tissue (MALT) lymphoma after Helicobacter pylori eradication
复制标题
DOI：
10.1136/gut.49.4.584
复制
发表时间：
2001-10-01
期刊：
影响因子：
24.5
通讯作者：
Bellas, C
中科院分区：
文献类型：
--
作者：
Montalban, C;Santon, A;Bellas, C
背景--大多数起源于粘膜相关淋巴组织（MALT）的低度胃淋巴瘤与幽门螺杆菌定植有关。仅限于胃部的病例在根除幽门螺杆菌后可以治愈，并保持缓解数年。与此相反，高级别的胃淋巴瘤，虽然也与幽门螺杆菌，通常不响应根除treatment.Case report-A 36岁的患者被转介从另一家医院诊断为低级别胃MALT淋巴瘤与幽门螺杆菌。该患者处于I期，在等待审查活检时，给予幽门螺杆菌根除治疗作为治疗的第一步。活检审查显示高级别免疫母细胞淋巴瘤伴低级别胃MALT淋巴瘤区域（高级别胃MALT淋巴瘤或弥漫性大B细胞淋巴瘤伴WHO分类的MALT型淋巴瘤区域）。患者没有接受进一步的治疗，但已密切跟进了32个月，连续内镜活检组织学研究，幽门螺杆菌文化，和聚合酶链反应分析的IgH gene.Results-After幽门螺杆菌根除患者有一个完整的组织学反应，已维持了32个月。单克隆IgH基因重排持续了32 months. Conclusion-This患者的反应表明，一些情况下，高级别胃MALT淋巴瘤（可能是患者在第一阶段与浅表或有限的疾病）的可能性，可能仍然是响应幽门螺杆菌抗原驱动器，并可能与根除治疗治愈。应进行前瞻性研究，以确定高级别胃MALT淋巴瘤患者可能对根除治疗有反应，并避免其他更积极的治疗。
Background-Most low grade gastric lymphomas arising from the mucosa associated lymphoid tissue (MALT) are related to Helicobacter pylori colonisation. Cases with disease limited to the stomach can be cured after H pylori eradication and remain in remission for years. In contrast, high grade lymphomas of the stomach, although also related to H pylori, do not usually respond to eradication treatment.Case report-A 36 year old patient was referred from another hospital with a diagnosis of a low grade gastric MALT lymphoma associated with H pylori. The patient was in stage I and while waiting for the biopsies to be reviewed H pylori eradication therapy was given as the first step of treatment. Review of the biopsies showed a high grade immunoblastic lymphoma with areas of low grade gastric MALT lymphoma (high grade gastric MALT lymphoma or diffuse large B cell lymphoma with areas of MALT type lymphoma of the WHO classification). The patient received no further treatment but has been closely followed up for 32 months with sequential endoscopies to obtain biopsies for histological studies, H pylori cultures, and polymerase chain reaction analysis of the IgH gene.Results-After H pylori eradication the patient had a complete histological response that has been maintained for 32 months. Monoclonal IgH gene rearrangement persisted for 32 months.Conclusion-The response of this patient indicates the possibility that some cases of high grade gastric MALT lymphoma (possibly patients in stage I with a superficial or limited disease) may still be responsive to H pylori antigenic drive and may be cured with eradication therapy. Prospective studies should be performed to identify patients with high grade gastric MALT lymphomas that may respond to eradication therapy and be spared of other more aggressive treatments.