[Diagnosis of early gastric marginal zone lymphoma (MALT lymphoma) in endoscopic biopsies. Report of a case that demonstrates the utility of immunohistochemistry and the molecular analysis.].
MALT lymphomas are a subtype of low grade lymphomas that represent 7-8% of all B-cell lymphomas originated in extranodal sites. Nearly 50% of the cases present as primary gastric lymphomas.They arise from the acquired MALT developed during the course of H. pylori chronic infection. Microscopically,the presence of lymphoid follicles with follicular colonization, marginal zone ("centrocytoid")cells and lymphoepithelial lesions is characteristic.Histopathological diagnosis may result difficult in superficial endoscopic biopsies showing a typical lymphoid infiltrates. Using Wotherspoon criteria along with molecular analyses is useful in borderline lesions. We present the case of a 62 years old female with chronic gastritis. A small endoscopic biopsy was performed and the presence of a heterogeneous lymphoid infiltrate in the lamina propia was observed. Immuno histochemical profile showed focal co expression of CD20 andCD43 and kappa light chain restriction. The diagnosis of an atypical lymphoid infiltrate highly suspicious of MALT lymphoma was established. PCR molecular analysis corroborated the monoclonal pattern of the lymphoid cells and the diagnosis of lymphoma. Immunohistochemical and molecular analyses in cases of lymphoid infiltrates suspicious of malignancy (Wotherspoon 3 and 4) will aid in the adequate diagnosis between chronic gastritis and MALT lymphoma, which is crucial for prognosis,treatment and patient's outcome.Key words: Chronic reactive gastritis, marginal zone lymphoma, MALT lymphoma, gastriclym.
Piña-Oviedo
S
S
Departamento de Biología Celular y Tisular. Escuela de Medicina. Universidad Panamericana. Donatello No. 59. Colonia Insurgentes Mixcoac.C.P. 03920, México D.F., México.
Fend
F
F
Kramer
M
M
Fournier
F
F
Farca
A
A
Ortiz-Hidalgo
C
C
D001706:Biopsy / Q000379:methods; D005260:Female; D005773:Gastroscopy; D006801:Humans; D007150:Immunohistochemistry; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology