Development of early gastric cancer 4 and 5 years after complete remission of Helicobacter pylori associated gastric low grade marginal zone B cell lymphoma of MALT type.
OBJECTIVE
To report 3 of 120 patients on the German MALT lymphoma trial with H. pylori associated gastric MALT lymphoma who developed early gastric cancer 4 and 5 years, after complete lymphoma remission following cure of H. pylori infection.


RESULTS
Three patients (two men, 74 and 70 years; one women, 77 years) with H. pylori-associated low-grade MALT lymphoma achieved complete lymphoma remission after being cured. Surveillance endoscopies were performed twice a year in accordance to the protocol. Four years after complete lymphoma remission in two patients, and after 5 years in the other, early gastric adenocarcinoma of the mucosa-type, type IIa and type IIc, respectively, was detected, which were completely removed by endoscopic mucosa resection. In one patient, the gastric cancer was diagnosed at the same location as the previous MALT lymphoma, in the other patients it was detected at different sites of the stomach distant from location of the previous MALT lymphoma. The patients were H. pylori negative during the whole follow-up time.


CONCLUSIONS
These findings strengthen the importance of regular Long-term follow-up endoscopies in patients with complete remission of gastric MALT lymphoma after cure of H. pylori infection. Furthermore, gastric adenocarcinoma may develop despite eradication of H. pylori.
Morgner
A
A
Medical Department I, Technical University Hospital, Fetscherstr.74, 01307 Dresden, Germany. bayerdoerffer@t-online.de
Miehlke
S
S
Stolte
M
M
Neubauer
A
A
Alpen
B
B
Thiede
C
C
Klann
H
H
Hierlmeier
F X
FX
Ell
C
C
Ehninger
G
G
Bayerdörffer
E
E
D000230:Adenocarcinoma / Q000382:microbiology* / Q000473:pathology*; D000368:Aged; D004198:Disease Susceptibility; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000382:microbiology* / Q000473:pathology* / Q000628:therapy; D008297:Male; D012074:Remission Induction; D013274:Stomach Neoplasms / Q000382:microbiology* / Q000473:pathology* / Q000628:therapy