1/91. Molecular relationships of helicobacter pylori strains in a family with gastroduodenal disease.OBJECTIVE: Few studies have examined the genetic relationships of helicobacter pylori strains affecting family members. Our aim was to do so. methods: We characterized H. pylori isolates obtained from members of a single family presenting with various gastroduodenal diseases to examine H. pylori bacterial genetic similarity. Endoscopic evaluation with gastric mapping was performed on each individual to establish clinical and histological disease. Genomic dna extracted from each H. pylori isolate was used to generate dna fingerprints for each strain by REP-PCR. vacA genotypes and cagA presence were established by PCR. RESULTS: gastrointestinal diseases among the five members of this family included gastric adenocarcinoma in a 52-yr-old man (index patient), gastric MALT-lymphoma in the 73-yr-old mother; intestinal metaplasia (IV) and atrophic gastritis in the 48-yr-old brother; intestinal metaplasia (I-III) in the 47-yr-old brother, and a duodenal ulcer scar in the 42-yr-old sister. REP-PCR dna fingerprints of H. pylori isolates from the index patient, his mother, and both of his brothers were identical or highly similar. By contrast, the H. pylori dna fingerprint from the sister was markedly different from the H. pylori dna fingerprints from the other family members. All isolates had the genotype cagA-positive and vacA slb/ml mosaic genotype. CONCLUSIONS: The dna fingerprints of H. pylori strains obtained from members of this family with malignancy or premalignant histological disease were identical or highly similar and markedly different from the H. pylori dna fingerprint from the sibling with duodenal ulcer disease. All H. pylori isolates within the family possessed genetic markers of enhanced virulence (presence of the cagA gene and vacA sl/ml mosaicism). In addition to host genetics and environmental factors, these findings suggest that infection with genetically similar H. pylori strains is a significant factor in determining the clinical outcome of an infection with H. pylori.- - - - - - - - - - ranking = 1keywords = lymphoma (Clic here for more details about this article) |
2/91. Simultaneous MALT-type lymphoma and early adenocarcinoma of the stomach associated with helicobacter pylori gastritis.We report about two cases of combined gastric lymphoma and gastric carcinoma with one of them representing a case of early gastric high grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) with co-existing early gastric adenocarcinoma. In contrast to most previously reported similar cases, in both of our cases the definitive diagnosis of gastric lymphoma and carcinoma was obtained preoperatively. This, however, seems to be in future times an essential prerequisite for employing minimal invasive methods such as eradication therapy in the case of diagnosed early lymphoma and endoscopic treatment for early gastric carcinomas. These methods have been proven to be an effective and beneficial alternative treatment especially with regard to the life quality of the patients.- - - - - - - - - - ranking = 8keywords = lymphoma (Clic here for more details about this article) |
3/91. Eradication of helicobacter pylori infection did not lead to cure of duodenal mucosa-associated lymphoid tissue lymphoma.Duodenal mucosa-associated lymphoid tissue (MALT) lymphoma is very rare, and little is known about its clinical course or association with helicobacter pylori infection. This report describes the case of a 76-year-old man with a polypoid mass in the duodenal bulb, diagnosed as low-grade MALT lymphoma. H. pylori infection in the duodenal mucosa was confirmed by histology with silver stain. Endoscopic examination showed that the gross lesion regressed after the eradication of H. pylori despite its histopathologic persistence. Ten months later, however, cervical and intraperitoneal lymphadenopathy and bone marrow involvement was observed, and the pathologic diagnosis of the cervical lymph node was identical with that of the duodenal lesion.- - - - - - - - - - ranking = 6keywords = lymphoma (Clic here for more details about this article) |
4/91. Spontaneous regression of malignant lymphoma of the stomach.We report a case of complete and spontaneous regression of malignant lymphoma of the stomach. A submucosal tumor with central ulceration was detected on the greater curvature of the stomach in a 63-year-old woman. The tumor was diagnosed histopathologically as a diffuse large B-cell lymphoma (REAL classification). The tumor disappeared 18 days later without chemotherapy. Examination at that stage showed helicobacter pylori (H. pylori), which was later treated with antibiotics. There was no evidence of recurrence of the malignant lymphoma at the last follow-up conducted at the time of preparation of this report, 13 months after the initial diagnosis. Spontaneous regression of an intermediate and high-grade non-Hodgkin's lymphoma is uncommon. We discuss the possible role of H. pylori in the regression of gastric malignant lymphomas.- - - - - - - - - - ranking = 9keywords = lymphoma (Clic here for more details about this article) |
5/91. Rapidly growing primary gastric B-cell lymphoma after eradication of helicobacter pylori.helicobacter pylori (H. pylori) infection plays a decisive role in primary gastric B-cell lymphoma especially of mucosa-associated lymphoid tissue (MALT)-type. We treated a 47-year-old male patient with primary gastric B-cell lymphoma associated with H. pylori infection. Although antibiotic therapy for eradication of H. pylori caused great improvement in the low-grade MALT lymphoma-like lesion, the small areas of high-grade lesion rapidly formed a new bulky mass in only 8 weeks. This suggests that eradication of H. pylori is not effective for high-grade lymphoma.- - - - - - - - - - ranking = 8keywords = lymphoma (Clic here for more details about this article) |
6/91. Minimal endoscopic aspects of gastric low-grade malt-lymphoma.Low-grade gastric MALT-lymphoma is a neoplasia with a very indolent course and an excellent prognosis. Even if the most common endoscopic findings have described non-specific aspects, often suggestive for benign conditions, the endoscopy reveals a wide range of gastric mucosal changes both at diagnosis and at relapse. We report 2 cases of low-grade gastric MALT-lymphoma in which the diagnosis was made casually because the endoscopic presentation consisted only in mucosal hyperaemia in 1 case and in normal-appearing mucosa of the stomach in the second case. The patients were successfully treated with anti-helicobacter pylori therapy. At 18 and 12 months of follow-up, respectively, the patients were disease-free. The bland appearance of this disease in some patients may reflect the early diagnosis of the tumor. Even if endoscopy and echoendoscopy often constitute useful and reliable diagnostic procedures, in the early phases of the tumor the histologic evaluation of endoscopic biopsies including immunohistochemistry represent the diagnostic procedure more reliably to detect this neoplasm.- - - - - - - - - - ranking = 6keywords = lymphoma (Clic here for more details about this article) |
7/91. Regression of colonic low grade B cell lymphoma of the mucosa associated lymphoid tissue type after eradication of helicobacter pylori.BACKGROUND: lymphoma of the mucosa associated lymphoid tissue (MALT) arising in the stomach has been shown to be related to helicobacter pylori infection, and total regression of gastric lymphoma after successful eradication of H pylori has consistently been reported. MALT-type lymphoma at other localisations, however, has to our knowledge not been linked to H pylori, and eradication of the bacteria has not been studied for management of such lymphomas. PATIENT/METHOD: A 67 year old man was diagnosed with MALT-type lymphoma simultaneously involving the stomach and the colon descendens. In addition to the presence of MALT-type lymphoma, H pylori associated chronic gastritis was diagnosed, and treatment with clarithromycin, metronidazole, and omeprazole was initiated, resulting in its successful eradication. RESULTS: Follow up performed four months later showed regression of the colonic manifestation, whereas the gastric lymphoma did not respond to antibiotic treatment, as assessed by regular follow up for 14 months, in spite of its restriction to mucosa and submucosa. The patient was therefore treated with oral cyclophosphamide (100 mg a day) resulting in partial remission after seven months of continuous treatment. Because of the presence of residual lymphoma, additional irradiation was performed, which led to complete remission of the gastric lymphoma. The patient remains in complete remission 40 months after diagnosis and 26 months after initiation of treatment. CONCLUSION: In the case of concurrent gastric and intestinal low grade MALT-type lymphoma, H pylori eradication may cause regression of the intestinal lesion.- - - - - - - - - - ranking = 13keywords = lymphoma (Clic here for more details about this article) |
8/91. gastric mucosa as an additional extrahepatic localization of hepatitis c virus: viral detection in gastric low-grade lymphoma associated with autoimmune disease and in chronic gastritis.The hepatitis c virus (HCV) has been linked to B-cell lymphoproliferation and autoimmunity, and has been localized in several tissues. The clinical observation of an HCV-infected patient with sjogren's syndrome (SS) and helicobacter pylori (HP) positive gastric low-grade B-cell non-Hodgkin's lymphoma (NHL), which did not regress after HP eradication, led us to investigate the possible localization of HVC in the gastric microenvironment. HCV genome and antigens were searched in gastric biopsy specimens from the previously mentioned case, as well as from 9 additional HCV-infected patients (8 with chronic gastritis and 1 with gastric low-grade B-cell NHL). HCV-specific polymerase chain reaction (PCR) and immunohistochemistry procedures were used. The gastric B-cell NHL from the patient with SS was characterized by molecular analyses of B-cell clonality. HCV rna was detected in both the gastric low-grade B-cell NHL and in 3 out of 6 gastric samples from the remaining cases. HCV antigens were detected in the residual glandular cells within the gastric B-cell NHL lesions, in glandular cells from 2 of the 3 additional gastric lesions that were HCV positive by PCR, and in 1 additional chronic gastritis sample in which HCV-rna studies could not be performed. By molecular analyses, of immunoglobulin genes, the B-cell NHL from the patient with SS was confirmed to be a primary gastric lymphoma, subjected to ongoing antigenic stimulation and showing a significant similarity with rheumatoid factor (RF) and anti-HCV- antibody sequences. Our results show that HCV can localize in the gastric mucosa.- - - - - - - - - - ranking = 6keywords = lymphoma (Clic here for more details about this article) |
9/91. Burkitt's lymphoma associated with helicobacter pylori.The association between helicobacter pylori infection and low grade mucosa-associated lymphoid tissue lymphoma is now widely accepted. In this report, we describe the concurrent development of Burkitt's lymphoma in the stomach of a 53-year-old male with perforated duodenal ulcer and positive H. pylori serology. The temporal relationship between these two events raises the possibility of a causal link between H. pylori infection and this lymphoproliferative disease. In describing this rare case of gastric Burkitt's lymphoma, we consider the evidence that supports this possibility.- - - - - - - - - - ranking = 7keywords = lymphoma (Clic here for more details about this article) |
10/91. Regression of gastric mucosa-associated lymphoid tissue lymphoma with reduced telomerase activity after eradication of helicobacter pylori.Recently, telomerase activity has been demonstrated in a large number of malignant tumors whereas its activity is not detected in most normal somatic cells suggesting its role in the immortalization process. Here we report the first investigation of telomerase activity in a case of gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Elevated telomerase activity was detected in biopsy specimens of the lymphoma. After eradication of helicobacter pylori, the level of telomerase activity returned to normal with histological regression of the lymphoma. The telomerase activity was associated with the disease activity of the gastric MALT lymphoma after eradication therapy in the present case.- - - - - - - - - - ranking = 8keywords = lymphoma (Clic here for more details about this article) |
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