Complete remission of gastric Burkitt's lymphoma after eradication of Helicobacter pylori.
Burkitt's lymphoma is a highly aggressive non-Hodgkin lymphoma, often presenting in extra-nodal sites. It generally has a poor spontaneous outcome and needs aggressive treatment with systemic and intrathecal chemotherapy. Occurrence at the gastric site is rare. We report the case of a 39-year old woman who presented with a prominent ulcerated lesion of the antrum corresponding histologically to a Burkitt's lymphoma associated with Helicobacter pylori (H pylori) infection. Interphase fluorescence in situ hybridization (FISH) demonstrated c-MYC gene rearrangement in tumour cells without BCL2 or BCL6 gene translocations. Ulcer healing and tumour regression with a complete histological response were obtained 8 wk after H pylori eradication. In spite of this complete remission, taking into account the high risk of recurrence, the patient received systemic and intrathecal chemotherapy. Two years later, the patient remained in complete remission. This is the first report of a gastric Burkitt's lymphoma responding to H pylori eradication. These findings raise the question of the potential role of H pylori in the pathogenesis of some gastric Burkitt's lymphomas, and show the importance of searching for and eradicating the bacteria in combination with conventional chemotherapy regimens.
Baumgaertner
Isabelle
I
Department of Gastroenterology, AP-HP, Henri Mondor Hospital, Paris 12 University, Créteil, France. jean-charles.delchier@hmn.aphp.fr
Copie-Bergman
Christiane
C
Levy
Michael
M
Haioun
Corinne
C
Charachon
Antoine
A
Baia
Maryse
M
Sobhani
Iradj
I
Delchier
Jean-Charles
JC
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use; D000328:Adult; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D002051:Burkitt Lymphoma / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D000077402:Pantoprazole; D012074:Remission Induction; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D000077402:Pantoprazole