Low-grade MALT Lymphoma of the Superficial Type Regressing after Helicobacter pylori Eradication Followed up by Endoscopic Examination Over a Long Time, Report of a Case Masahiro Okochi 1 , Yoshihumi Yokoyama 1 , Naotsuka Okayama 1 , Makoto Sasaki 1 , Makoto Ito 1 1The First Department of Internal Medicine, Nagoya City University Medical School Keyword: 胃MALTリンパ腫 , Helicobacter pylori除菌治療 , 除菌後内視鏡像 pp.1437-1444
Published Date 1999/10/25
DOI https://doi.org/10.11477/mf.1403102853
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 Patients with gastric MALT (mucosa-associated lymphoid tissue) lymphoma have been divided into two groups (the regression and the non-regression group) after Helicobacter pylori (H.p.) eradication. However, few investigators have reported what type of MALT lymphoma will regress due to H.p. eradication. We reported a case of low-grade MALT lymphoma which regressed with H.p. eradication and discussed the difference between the regression and non-regression group, and the morphological changes after H.p. eradication from reviews of the literature. In a 72-year-old male, the endoscopic examination revealed coarse granular mucosa, multiple irregular erosions, and mixed reddish and whitish mucosa spreading in the gastric angulus to the antrum. The histological specimens from endoscopic mucosal resection were diagnosed as low-grade MALT lymphoma. Because H.p. examination was possitive,H.p. eradication was performed with tripple therapy consisting of a two-week course of oral lansoprazole, clarithromycin and tinidazole. The pathological biopsy specimens after H.p. eradication showed that MALT lymphoma had disappeard and H.p. examination gave negative results. The endoscopic examination after H.p. eradication revealed that the reddish and erosive gastric lesions had disappeared and changed into smooth whitish lesions. For over three years without any treatment the patient has experienced no relapse of MALT lymphoma or H.p..

 Some reports and our case suggest that the regression group after H.p. eradication can be predicted by a combination of the endoscopic and histological findings, and examination by endoscopic ultrasonography. Moreover, when reddish and erosive gastric lesions in patients with low-grade MALT lymphoma of the superficial type have changed into no erosive and smooth whitish lesions after H.p. eradication, we can presume the histological regression of MALT lymphoma.

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