Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
, 6, 35

High Grade B-cell Gastric Lymphoma With Complete Pathologic Remission After Eradication of Helicobacter Pylori Infection: Report of a Case and Review of the Literature

Affiliations
Review

High Grade B-cell Gastric Lymphoma With Complete Pathologic Remission After Eradication of Helicobacter Pylori Infection: Report of a Case and Review of the Literature

Luigi Cavanna et al. World J Surg Oncol.

Abstract

Background: Treatment of primary gastric diffuse large B-cell lymphoma is still controversial. The treatment of localized disease was based on surgery alone, or followed by chemotherapy and/or radiotherapy. High-grade gastric lymphomas are generally believed to be Helicobacter pylori (HP)-independent growing tumors. However a few cases of regression of high-grade gastric lymphomas after the cure of Helicobacter pylori infection had been described.

Case presentation: We report here a case with primary diffuse large B-cell lymphoma that showed a complete pathologic remission after HP eradication and we reviewed the literature. A computerized literature reach through Medline, Cancerlit and Embase were performed, applying the words: high grade gastric lymphoma, or diffuse large B cell, MALT gastric lymphoma, DLBCLL (MALT) lymphoma and Helicobacter. Articles and abstracts were also identified by back-referencing from original and relevant papers. Selected for the present review were papers published in English before January 2007.

Conclusion: Forty two cases of primary high grade gastric lymphoma that regressed with anti HP treatment were found. There were anecdotal cases reported and patients belonging to prospective studies; four trials studied the effect of eradication of Helicobacter pylori as first line therapy in high grade gastric lymphoma: 22 of a total of 38 enrolled patients obtained complete remission. Depth of gastric wall infiltration and clinical stage were important factors to predict the response to antibiotic therapy. Our case and the review of the literature show that high-grade transformation is not necessarily associated with the loss HP dependence. In early stage, for high-grade B-cell HP-positive gastric lymphomas, given the limited toxicity of anti-HP therapy, this treatment may be considered as one of the first line treatment options.

Figures

Figure 1
Figure 1
Histology before triple therapy shows antral gastric mucosa exhibiting interstitial infiltrate composed of large sized centroblast-like lymphoid cells (inset), with occasional lymphoepithelial lesions (arrows) (Giemsa, inset H&E ×200).
Figure 2
Figure 2
Histology after triple therapy shows antral gastric mucosa with sparse lymphoplasmacellular interstitial infiltrate, without evidence of lymphomatous cells (H&E ×200).

Similar articles

See all similar articles

Cited by 15 PubMed Central articles

See all "Cited by" articles

References

    1. Wotherspoon AC, Ortiz-Hidalgo C, Falzon MR, Isaacon PG. Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma. Lancet. 1991;338:1175–1176. doi: 10.1016/0140-6736(91)92035-Z. - DOI - PubMed
    1. Parsonnet J, Hansen S, Rodriguez L, Gelb AB, Warnke RA, Jellum E, Orentreich N, Vogelman JH, Friedman GD. Helicobacter pylori infection and gastric lymphoma. N Engl J Med. 1994;330:1267–1271. doi: 10.1056/NEJM199405053301803. - DOI - PubMed
    1. Du MQ, Isaacson PG. Gastric MALT lymphoma: from etiology to treatment. Lancet Oncol. 2002;3:97–104. doi: 10.1016/S1470-2045(02)00651-4. - DOI - PubMed
    1. Hussell T, Isaacson PG, Crabtree JE, Spencer J. The response of cells from low-grade B-cell gastric lymphomas of mucosa-associated lymphoid tissue to Helicobacter pylori. Lancet. 1993;342:571–574. doi: 10.1016/0140-6736(93)91408-E. - DOI - PubMed
    1. Neubauer A, Thiede C, Morgner A, Alpen B, Ritter M, Neubauer B, Wundisch T, Ehninger G, Stolte M, Bayerdorffer E. Cure of Helicobacter pylori infection and duration of remission of low-grade gastric mucosa-associated lymphoid tissue lymphoma. J Natl Cancer Inst. 1997;89:1350–1355. doi: 10.1093/jnci/89.18.1350. - DOI - PubMed

MeSH terms

Feedback