title: Are lymphocytic monoclonality and immunoglobulin heavy chain (IgH) rearrangement premalignant conditions in chronic gastritis?
abstract: Normal gastric mucosa is devoid of lymphoid cells. Any increase of lymphocytes suggests chronic inflammation. Infection with Helicobacter pylori (Hp) is the major cause for nonautoimmune chronic gastritis and induces a mixed cellular response resulting in an acquired lymphoid tissue, or MALT (mucosa-associated lymphoid tissue). Hp has also been implicated in the genesis of gastric MALT-lymphoma. Polymerase chain reaction-based assays to detect the expansion of monoclonal B-cells have also been used to corroborate the diagnosis. In a considerable number of cases monoclonal B-cells remain detectable in follow-up biopsies, with the lymphoma being in complete histological remission. The clinical relevance of this finding is not clear yet. However, there also exist different reports that monoclonal B-cells can be found in gastric biopsies of patients with neither a histological sign nor a present or past history of lymphoma. In the light of these findings we address the question whether B-cell monoclonality can be seen as a premalignant condition in chronic gastritis and conclude that as of now the relevance of the finding of B-cell monoclonality remains unclear. As of now the only and gold standard for the diagnosis of gastric MALT-lymphoma is histopathology.
authors.affiliation: Abteilung für Hämatologie, Onkologie und Immunologie, Philipps Universität, Marburg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Wündisch
authors.forename: C
authors.initials: C
authors.lastname: Thiede
authors.forename: B
authors.initials: B
authors.lastname: Alpen
authors.forename: M
authors.initials: M
authors.lastname: Stolte
authors.forename: A
authors.initials: A
authors.lastname: Neubauer
mesh_terms: D001402:B-Lymphocytes / Q000473:pathology*; D001706:Biopsy; D002908:Chronic Disease; D005753:Gastric Mucosa / Q000473:pathology; D005756:Gastritis / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D015321:Gene Rearrangement; D005803:Genes, Immunoglobulin; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics*; D018442:Lymphoma, B-Cell, Marginal Zone / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D016133:Polymerase Chain Reaction; D011230:Precancerous Conditions / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D013274:Stomach Neoplasms / Q000235:genetics / Q000276:immunology / Q000473:pathology*
chemical_list: D007143:Immunoglobulin Heavy Chains