Regression of Gastric Low-grade MALT Lymphoma after Eradication of Helicobacter pylori Toshiyuki Kato 1 , Kazuei Ogoshi 1 , Nobuhiro Akiyama 1 1Division of Internal Medicine, Niigata Cancer Center Hospital Keyword: 胃悪性リンパ腫 , low-grade MALTリンパ腫 , Helicobacter pylori除菌治療 , 完全寛解 , IgH再構成 pp.1345-1352
Published Date 1999/10/25
DOI https://doi.org/10.11477/mf.1403102838
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 Eradication of H.pylori may lead to the complete-remission of gastric low-grade MALT lymphoma both endoscopically and histologically. Out of 19 eradicated cases,16 cases showed complete-remission (CR 84.2%), two showed partial-remission (PR 10.5%) and one showed no-response (NC 5.3%).

 After eradication of H.pylori, the mucosal lesion changed to a flat and discolored area. This flat and discolored atrophy is the characteristic finding of MALT lymphoma in the remission stage. Furthermore, it will take some time, nearly one-year, for the mucosa to regain its normal appearance.

 In the follow-up period of 6 to 54 months (average 21 months), neither relapse of MALT lymphoma nor reinfection by H.pylori were observed in complete-remission cases.

 On the other hand, a small amount of residual tumor cells and persistence of IgH monoclonality are still observed in three of the partial-remission or no-response cases. No aggravation of the lesion has been observed during a 12-months follow-up period. Therefore, genetic or molecular biology methods are required to determine whether the remission of MALT lymphoma is complete or not.

 Chemotherapy is the follow-up treatment of choice for partial-remission or no-response cases. However, the starting period for chemotherapy is hard to determine, because no aggravation is observed during the initial period following partial-remission.

 The next problem in the follow-up of MALT lymphoma is to see whether it is in combination with gastric cancer. Two cases of combined malignancy of MALT lymphoma and gastric cancer were observed in our series.

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