Saito M, Tanei ZI, Tsuda M, Suzuki T, Yokoyama E, Kanaya M, Izumiyama K, Mori A, Morioka M, Kondo T. Transformed gastric mucosa-associated lymphoid tissue lymphoma originating in the colon and developing metachronously after Helicobacter pylori eradication: A case report. World J Gastrointest Oncol 2024; 16(10): 4281-4288 [DOI: 10.4251/wjgo.v16.i10.4281]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Oct 15, 2024; 16(10): 4281-4288 Published online Oct 15, 2024. doi: 10.4251/wjgo.v16.i10.4281
Transformed gastric mucosa-associated lymphoid tissue lymphoma originating in the colon and developing metachronously after Helicobacter pylori eradication: A case report
Makoto Saito, Toma Suzuki, Emi Yokoyama, Minoru Kanaya, Koh Izumiyama, Akio Mori, Masanobu Morioka, Takeshi Kondo, Blood Disorders Center, Aiiku Hospital, Sapporo 064-0804, Hokkaido, Japan
Zen-Ichi Tanei, Masumi Tsuda, Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Sapporo 060-8638, Hokkaido, Japan
Author contributions: Saito M designed this study and wrote the manuscript; Tanei ZI and Tsuda M involved in pathological procedure and technical support for molecular medicine in this study; All authors made substantial contributions to acquisition of data, or analysis and interpretation of data; took part in drafting the article; and agree to be accountable for all aspects of the work.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Received: June 10, 2024 Revised: August 18, 2024 Accepted: August 27, 2024 Published online: October 15, 2024 Processing time: 108 Days and 7.6 Hours
Abstract
BACKGROUND
Helicobacter pylori (H. pylori) eradication treatment for primary gastric mucosa-associated lymphoid tissue (MALT) lymphoma has already been established. However, t (11;18) (q21;q21)/API2-MALT1 translocation-positive lesions are a type of primary gastric MALT lymphoma in which a response to eradication treatment is difficult to achieve. In addition, trisomy 18 may be associated with diffuse large B-cell lymphoma (DLBCL) transformation of gastric MALT lymphoma.
CASE SUMMARY
A 66-year-old man was diagnosed with MALT lymphoma in the ascending colon by colonoscopy and biopsy. Two years later, esophagogastroduodenoscopy revealed chronic atrophic gastritis that was positive for H. pylori, and eradication treatment was administered. Two years and nine months later (at the age of 70), a new ulcerative lesion suggestive of MALT lymphoma appeared in the gastric body, and six months later, a similar lesion was also found in the fundus. One year later (4 years and 3 months after H. pylori eradication), at the age of 72, the lesion in the gastric body had become deeper and had propagated. A biopsy revealed a pathological diagnosis of DLBCL. Both MALT lymphoma lesions in the ascending colon and DLBCL lesions in the stomach were positive for the t (11;18) (q21;q21)/API2-MALT1 translocation, and trisomy 18q21 was also detected. After 6 courses of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) chemotherapy, all of the above lesions disappeared [complete remission (CR)], and CR has been maintained for more than 3 years. In addition, both the colonic and gastric lesions were proven to have the same clonality.
CONCLUSION
Because the patient had a MALT1 translocation with trisomy 18q21, it was thought that this gastric MALT lymphoma developed independently of H. pylori infection and progressed.
Core Tip: Helicobacter pylori (H. pylori) eradication treatment is expected to be effective for treating mucosa-associated lymphoid tissue (MALT) lymphoma originating not only from the stomach but also from the colon. However, t (11;18) (q21;q21)/API2-MALT1 translocation is difficult to achieve a response to H. pylori eradication treatment for primary gastric MALT lymphoma. In this study, H. pylori eradication treatment performed for chronic atrophic gastritis was not only ineffective against initial colonic MALT lymphoma but also failed to prevent the subsequent development of gastric MALT lymphoma and further transformed diffuse large B-cell lymphoma. Because this lesion had a MALT1 translocation with trisomy 18q21, it was thought that the disease developed independently of H. pylori infection and progressed.
