Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 28, 2006; 12(16): 2625-2628
Published online Apr 28, 2006. doi: 10.3748/wjg.v12.i16.2625
Remission of primary low-grade gastric lymphomas of the mucosa-associated lymphoid tissue type in immunocompromised pediatric patients
Yasuharu Ohno, Taichirou Kosaka, Izumi Muraoka, Takashi Kanematsu, Akira Tsuru, Eiichi Kinoshita, Hiroyuki Moriuchi
Yasuharu Ohno, Taichirou Kosaka, Izumi Muraoka, Takashi Kanematsu, Division of Pediatric Surgery, Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
Akira Tsuru, Eiichi Kinoshita, Hiroyuki Moriuchi, Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Yasuharu Ohno MD, PhD, Department of Pediatric Surgery, Saitama Medical School Hospital, 38 Morohongo, Moroyama, Iruma, Saitama, 350-0495, Japan. ohno_y@saitama-med.ac.jp
Telephone: +81-49-2761654 Fax: +81-49-2761654
Received: October 26, 2005
Revised: January 9, 2006
Accepted: January 14, 2006
Published online: April 28, 2006
Abstract

We report the remission of primary gastric lymphoma of the mucosa-associated lymphoid tissue (MALT) type in two immunocompromised pediatric patients. Patient 1, a 14-year-old boy in an immunocompromised state of unknown cause, complained of repeated abdominal pain. Examinations revealed gastric MALT with local invasion and lymph node involvement. Serum anti-Helicobacter pylori (H pylori) antibody was positive. H pylori eradication was abandoned due to its adverse effects. The MALT lesion spontaneously regressed over the next 24 months without any treatment for lymphoma. Patient 2, a 6-year-old boy, underwent cord blood transplantation for the treatment of adrenoleukodystrophy. He was administered immunosuppressants for graft-versus-host disease after transplantation. Nausea and hematochezia appeared and further examinations revealed gastric MALT with H pylori gastritis. Treatment consisting of medication for the H pylori infection alone eradicated the H pylori and completely resolved the patient’s MALT lesion, as well. Patients 1 and 2 were followed up over periods of 10 years and 3 years, respectively, without any signs of relapse. In conclusion, gastric lymphoma of the MALT type can be cured by conservative treatment even in immunocompromised pediatric patients.

Keywords: Pediatric gastric lymphoma, Mucosa-associated lymphoid tissue, Immunocompromised states