Simultaneous gastric adenocarcinoma and MALT-type lymphoma in Helicobacter pylori infection.
A 79-year-old women with upper abdominal pain, vomiting and weight loss was found at endoscopy to have a large tumour mass in the gastric body. Histology of forceps biopsies revealed an adenocarcinoma of intestinal type. Gastrectomy was performed, but extensive lymph node metastasis precluded a curative surgical approach. Histopathological study of the specimen, however, revealed two distict malignancies, which arose in the setting of Helicobacter pylori-associated chronic gastritis with partial mucosal atrophy. One tumour was a gastric carcinoma, while the other was a primary B-cell lymphoma of the stomach (CD20-positive). The lymphoma comprised both a low-grade component (mucosa-associated lymphoid tissue- or MALT-type lymphoma), and a high-grade component (large cell lymphoma with CD30-positive giant cells). Infection with H. pylori was confirmed by the serological presence of IgG antibodies to H. pylori-antigens, including antibodies against the 128 kDa protein of the cytotoxin-associated gene (cagA gene) of H. pylori.
Pathologisches Institut der Universität, Heidelberg, Germany.
A
A
von Herbay
H
H
Schreiter
J
J
Rudi
D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000473:pathology*; D009378:Neoplasms, Multiple Primary / Q000150:complications / Q000473:pathology*; D013274:Stomach Neoplasms / Q000473:pathology*