Original Articles
Copyright ©The Author(s) 2001. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 15, 2001; 7(2): 248-253
Published online Apr 15, 2001. doi: 10.3748/wjg.v7.i2.248
Development of early gastric cancer 4 and 5 years after complete remission of Helicobacter pylori associated gastric low grade marginal zone B cell lymphoma of MALT type
Andrea Morgner, Stephan Miehlke, Manfred Stolte, Andreas Neubauer, Birgit Alpen, Christian Thiede, Hermann Klann, Franz Xaver Hierlmeier, Christian Ell, Gerhard Ehninger, Ekkehard Bayerdörffer
Andrea Morgner, Stephan Miehlke, Christian Thiede, Gerhard Ehninger, Ekkehard Bayerdörffer, Medical Department I, Technical University Hospital, Fetscherstr. 74, Dresden
Manfred Stolte, Institute for Pathology, Klinikum Bayreuth, Preuschwitzer Str. 101, Bayreuth
Andreas Neubauer, Birgit Alpen, Centre for Internal Medicine, Universityhospital, Baldingerstr., Marburg
Hermann Klann, Private Gastroenterologist, Exerzierplatz 12, Passau
Franz Xaver Hierlmeier, Med. Dept., Krankenhaus Kehlheim, Kehlheim
Christian Ell, Centre for Internal Medicine, HSK, Ludwig-Erhard-Str. 100, Wiesbaden, Germany
Author contributions: All authors contributed equally to the work.
Correspondence to: Ekkehard Bayerdörffer, M.D., Medical Department I, Technical University Hospital, Fetscherstr. 74, 01307 Dresden, Germany. bayerdoerffer@t-online.de
Telephone: +49-351-4585645 Fax: +49-351-4584394
Received: February 6, 2001
Revised: February 22, 2001
Accepted: March 1, 2001
Published online: April 15, 2001

AIM: To report 3 of 120 patients on the German MALT lymphoma trial with H. pylori associated gastric MALT lymphoma who developed early gastric cancer 4 and 5 years, after complete lymphoma remission following cure of H. pylori infection.

PATIENTS AND RESULTS: Three patients (two men, 74 and 70 years; one women, 77 years) with H. pylori-associated low-grade MALT lymphoma achieved complete lymphoma remission after being cured. Surveillance endoscopies were performed twice a year in accordance to the protocol. Four years after complete lymphoma remission in two patients, and after 5 years in the other, early gastric adenocarcinoma of the mucosa-type, type II a and type II c, respectively, was detetcted, which were completely removed by endoscopic mucosa resection. In one patient, the gastric cancer was diagnosed at the same location as the previous MALT lymphoma, in the other patients it was detected at different sites of the stomach distant from location of the previous MALT lymphoma. The patients were H. pylori negative during the whole follow-up time.

CONCLUSION: These findings strengthen the importance of regular Long term follow-up endoscopies in patients with complete remission of gastric MALT lymphoma after cure of H. pylori infection. Furthermore, gastric adenocarcinoma may develop despite eradication of H. pylori.

Keywords: Helicobacter pylori/pathogenicity, stomach neoplasms/microbiology, lymphoma, mucosa associated lymphoid tissue/microbiology, follow up studies