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Case Reports
. 2001 Apr;7(2):248-53.
doi: 10.3748/wjg.v7.i2.248.

Development of early gastric cancer 4 and 5 years after complete remission of Helicobacter pylori associated gastric low grade marginal zone B cell lymphoma of MALT type

A Morgner  1 , S Miehlke, M Stolte, A Neubauer, B Alpen, C Thiede, H Klann, F X Hierlmeier, C Ell, G Ehninger, E Bayerdörffer
Affiliations
Case Reports

Development of early gastric cancer 4 and 5 years after complete remission of Helicobacter pylori associated gastric low grade marginal zone B cell lymphoma of MALT type

A Morgner et al. World J Gastroenterol. 2001 Apr.

Abstract

Aim: To report 3 of 120 patients on the German MALT lymphoma trial with H. pylori associated gastric MALT lymphoma who developed early gastric cancer 4 and 5 years, after complete lymphoma remission following cure of H. pylori infection.

Patients and results: Three patients (two men, 74 and 70 years; one women, 77 years) with H. pylori-associated low-grade MALT lymphoma achieved complete lymphoma remission after being cured. Surveillance endoscopies were performed twice a year in accordance to the protocol. Four years after complete lymphoma remission in two patients, and after 5 years in the other, early gastric adenocarcinoma of the mucosa-type, type IIa and type IIc, respectively, was detected, which were completely removed by endoscopic mucosa resection. In one patient, the gastric cancer was diagnosed at the same location as the previous MALT lymphoma, in the other patients it was detected at different sites of the stomach distant from location of the previous MALT lymphoma. The patients were H. pylori negative during the whole follow-up time.

Conclusion: These findings strengthen the importance of regular Long-term follow-up endoscopies in patients with complete remission of gastric MALT lymphoma after cure of H. pylori infection. Furthermore, gastric adenocarcinoma may develop despite eradication of H. pylori.

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Figures

Figure 1
Figure 1
Endoscopic mucosa resection (EMR) in patient #2. A. Early gastric adenocarcinoma (EGC) in the antrum; φ 0.4 cm, m-type, B. EGC in the antrum; φ 0.4 cm, m-type after injection of suprarenine, C. Mucosa after EMR, D. Ulcer after EMR, treatment with argon beamerplasma coagulation, E. H&E stain of the endoscopically resected mucosa showing a gastric intestinal type adenocarcinoma, restricted to the mucosa (m-type)
Figure 2
Figure 2
Medians of the summed gastritis score in antrum and corpus, formed by adding together the respective values of grade and activity of gastritis, replacement of foveolae by regenerative epithelium, and density of H. pylori colonization as presented in Reference 24.
See this image and copyright information in PMC

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