Relapse of MALT Lymphoma Three Years after the Initial Antibiotic Therapy for Helicobacter pylori, Report of a Case Kotaro Yamaguchi 1 , Hidenobu Watanabe 2 , Hiroko Yamashita 2 , Hiroshi Iesato 3 , Tadao Nakamura 4 1Yamaguchi Clinic 2The First Department of Pathology, Niigata University School of Medicine 3Department of Surgery, Ojiya General Hospital 4Nakamura Clinic Keyword: MALTリンパ腫 , Helicobacter pylori , 除菌療法 , 再発 , 手術 pp.1429-1435
Published Date 1999/10/25
DOI https://doi.org/10.11477/mf.1403102851
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 We report an operated case of recurrence of mucosa-associated lymphoid tissue (MALT) lymphoma in a 58-year-old female. In our previous report, the case was diagnosed as a low-grade MALT lymphoma with Helicobacter pylori (Hp) by macroscopic (Fig.2), pathological, and molecular biological findings. After initial antibiotic therapy, both macroscopic and microscopic studies (Fig.3) including immunohistochemistry and molecular biology revealed no evidence of lymphoma, but Hp remained detectable. Follow-up studies showed no recurrence for 30 months, during which 50~100 mg of cyclophosphamide was administrated to the patient. In the examination performed 36 months after initial antibiotic therapy, the recurrence of lymphoma was detected as small and irregular-shaped erosions (Fig.6 c, d) at the large curvature of the corpus. The second course of antibiotic therapy using 20 mg of sodium rabeprazole,600 mg of clarithromycine,1,500 mg of amoxicillin, and 54,000 units of pronase completely eradicated Helicobacter pylori, but the finding of lymphoma still remained. The last examination performed three months after the second course of eradication therapy revealed the exacerbation of lymphoma (Fig.8). The operated specimen showed a high-grade MALT lymphoma with metastasis to the regional lymph nodes.

 The initial and follow-up studies were re-evaluated, and we conclude that the lesion was a high-grade MALT lymphoma from the initial stage of the clinical studies.

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