Systemic sclerosis and gastric MALT lymphoma.
METHODS
A 76-year-old woman was admitted for evaluation of esophagitis complicating limited cutaneous systemic sclerosis. Endoscopy showed persistent grade III esophagitis and an erythematous antral lesion found upon biopsy to be a lymphoma of mucosa-associated lymphoid tissue (MALT). Tests were positive for Helicobacter pylori. Moderate mucosal infiltration by endoscopic ultrasonography was the only finding from staging investigations. Six months after treatment to eradicate H. pylori, a repeat endoscopy showed no evidence of the lesion.


CONCLUSIONS
MALT lymphomas are usually confined to the gastric wall. Gastric MALT lymphomas have a well-established association with H. pylori infection. The clinical manifestations are nonspecific. Endoscopy usually shows a focus of erythema or, less often, erosion. The diagnosis rests on histological examination of a biopsy, which shows infiltration by monoclonal cells whose immunophenotype is characteristic of marginal-zone B cells. Eradication of H. pylori is the mainstay of treatment.
Service de Rhumatologie A, Hôpital Cochin, AP-HP, Université Paris V, France.
Laurent
L
Arnaud
Ariane
A
Chryssostalis
Benoît
B
Terris
Stephan
S
Pavy
Stanislas
S
Chaussade
André
A
Kahan
Yannick
Y
Allanore
D000368:Aged; D001706:Biopsy; D003937:Diagnosis, Differential; D018450:Disease Progression; D016099:Endoscopy, Gastrointestinal; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D009367:Neoplasm Staging; D012595:Scleroderma, Systemic / Q000150:complications* / Q000473:pathology; D013274:Stomach Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed