Clinical course of duodenal mucosa-associated lymphoid tissue lymphoma: Comparison with gastric mucosa-associated lymphoid tissue lymphoma.
Adult
Aged
Duodenum
/ pathology
Female
Gastric Mucosa
/ pathology
Helicobacter Infections
/ drug therapy
Helicobacter pylori
Humans
Intestinal Mucosa
/ pathology
Lymphatic Metastasis
Lymphoma, B-Cell, Marginal Zone
/ pathology
Male
Middle Aged
Rare Diseases
Remission Induction
Retrospective Studies
Treatment Outcome
Young Adult
Clinical feature
Duodenum
MALT lymphoma
Stomach
Journal
Journal of gastroenterology and hepatology
ISSN: 1440-1746
Titre abrégé: J Gastroenterol Hepatol
Pays: Australia
ID NLM: 8607909
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
20
01
2020
revised:
09
06
2020
accepted:
17
06
2020
pubmed:
24
6
2020
medline:
25
8
2021
entrez:
24
6
2020
Statut:
ppublish
Résumé
There are few cases of duodenal mucosa-associated lymphoid tissue (MALT) lymphoma reported in the literature, and little is known about the clinical course of this disease. Here, we aimed to characterize the clinical features of duodenal MALT lymphoma by comparison with gastric MALT lymphoma. Thirteen patients diagnosed with duodenal MALT lymphoma at Asan Medical Center from March 1997 to February 2017 were included in this retrospective study, along with patients with gastric MALT lymphoma, matched by age and sex at a 1:10 ratio. Median age of patients with duodenal MALT lymphoma was 49 (range 20-72) years, and 53.8% (7/13) were male. Comparison of patient characteristics indicated that Helicobacter pylori infection (46.2% vs 90.8%, P < 0.001) and lymph node metastasis (23.1% vs 5.4%, P = 0.049) rates differed between patients with duodenal and gastric MALT lymphoma. Overall complete remission (61.5% vs 86.2%, P = 0.021) and complete remission after initial H. pylori eradication therapy (50% vs 87.7%, P = 0.037) were significantly lower in patients with duodenal than gastric MALT lymphoma. Complications including bleeding, stricture, and transformation to high-grade lymphoma occurred in a total of seven patients (4.9%), with a higher incidence in patients with duodenal than gastric MALT lymphoma (38.5% vs 1.5%, P < 0.001). Duodenal MALT lymphoma is very rare, and treatment outcomes appear to be inferior to those of gastric MALT lymphoma.
Sections du résumé
BACKGROUND AND AIM
OBJECTIVE
There are few cases of duodenal mucosa-associated lymphoid tissue (MALT) lymphoma reported in the literature, and little is known about the clinical course of this disease. Here, we aimed to characterize the clinical features of duodenal MALT lymphoma by comparison with gastric MALT lymphoma.
METHODS
METHODS
Thirteen patients diagnosed with duodenal MALT lymphoma at Asan Medical Center from March 1997 to February 2017 were included in this retrospective study, along with patients with gastric MALT lymphoma, matched by age and sex at a 1:10 ratio.
RESULTS
RESULTS
Median age of patients with duodenal MALT lymphoma was 49 (range 20-72) years, and 53.8% (7/13) were male. Comparison of patient characteristics indicated that Helicobacter pylori infection (46.2% vs 90.8%, P < 0.001) and lymph node metastasis (23.1% vs 5.4%, P = 0.049) rates differed between patients with duodenal and gastric MALT lymphoma. Overall complete remission (61.5% vs 86.2%, P = 0.021) and complete remission after initial H. pylori eradication therapy (50% vs 87.7%, P = 0.037) were significantly lower in patients with duodenal than gastric MALT lymphoma. Complications including bleeding, stricture, and transformation to high-grade lymphoma occurred in a total of seven patients (4.9%), with a higher incidence in patients with duodenal than gastric MALT lymphoma (38.5% vs 1.5%, P < 0.001).
CONCLUSIONS
CONCLUSIONS
Duodenal MALT lymphoma is very rare, and treatment outcomes appear to be inferior to those of gastric MALT lymphoma.
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
406-412Informations de copyright
© 2020 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
Références
Isaacson P, Wright DH. Malignant lymphoma of mucosa-associated lymphoid tissue. A distinctive type of B-cell lymphoma. Cancer 1983; 52: 1410-1416.
The Non-Hodgkin's Lymphoma Classification Project. A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin's lymphoma. Blood 1997; 89: 3909-3918.
Kim JM, Ko YH, Lee SS et al. WHO classification of malignant lymphomas in Korea: report of the third nationwide study. Korean J. Pathol. 2011; 45: 254-260.
Ghimire P, Wu GY, Zhu L. Primary gastrointestinal lymphoma. World J. Gastroenterol. 2011; 17: 697-707.
Wotherspoon AC. Gastric lymphoma of mucosa-associated lymphoid tissue and Helicobacter pylori. Annu. Rev. Med. 1998; 49: 289-299.
Isaacson PG, Spencer J. Gastric lymphoma and Helicobacter pylori. Important Adv. Oncol. 1996: 111-121.
Ochi M, Tominaga K, Okazaki H et al. Regression of primary low-grade mucosa-associated lymphoid tissue lymphoma of duodenum after long-term treatment with clarithromycin. Scand. J. Gastroenterol. 2006; 41: 365-369.
Nagashima R, Takeda H, Maeda K, Ohno S, Takahashi T. Regression of duodenal mucosa-associated lymphoid tissue lymphoma after eradication of Helicobacter pylori. Gastroenterology 1996; 111: 1674-1678.
Swerdlow SH, Campo E, Pileri SA et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016; 127: 2375-2390.
Musshoff K. Clinical staging classification of non-Hodgkin's lymphomas (author's transl). Strahlentherapie 1977; 153: 218-221. German.
Radaszkiewicz T, Dragosics B, Bauer P. Gastrointestinal malignant lymphomas of the mucosa-associated lymphoid tissue: factors relevant to prognosis. Gastroenterology 1992; 102: 1628-1638.
Cheson BD, Fisher RI, Barrington SF et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J. Clin. Oncol. 2014; 32: 3059-3068.
Copie-Bergman C, Wotherspoon AC, Capella C et al. Gela histological scoring system for post-treatment biopsies of patients with gastric MALT lymphoma is feasible and reliable in routine practice. Br. J. Haematol. 2013; 160: 47-52.
Kim JH, Kim WS, Ko YH et al. Clinical investigation of gastric MALT lymphoma. Korean J. Med. 2001; 61: 417-423.
Woo KH, Kim JH, Yoon SB et al. Duodenal mucosa-associated lymphoid tissue lymphoma: a case report. Korean J. Intern. Med. 2007; 22: 296-299.
Xiang Z, Onoda N, Ohira M et al. Mucosa-associated lymphoid tissue lymphoma of the duodenum: report of a case resistant to Helicobacter pylori eradication. Hepatogastroenterology 2004; 51: 732-735.
Taal BG, den Hartog Jager FC, Tytgat GN. The endoscopic spectrum of primary non-Hodgkin's lymphoma of the stomach. Endoscopy 1987; 19: 190-192.
Kahl B, Yang D. Marginal zone lymphomas: management of nodal, splenic, and MALT NHL. Hematology Am. Soc. Hematol. Educ. Program 2008: 359-364. https://doi.org/10.1182/asheducation-2008.1.359
Bayerdorffer E, Neubauer A, Rudolph B et al. Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure of Helicobacter pylori infection. Lancet 1995; 345: 1591-1594.
Roggero E, Zucca E, Pinotti G et al. Eradication of Helicobacter pylori infection in primary low-grade gastric lymphoma of mucosa-associated lymphoid tissue. Ann. Intern. Med. 1995; 122: 767-769.
Pinotti G, Zucca E, Roggero E et al. Clinical features, treatment and outcome in a series of 93 patients with low-grade gastric MALT lymphoma. Leuk. Lymphoma 1997; 26: 527-537.
Gromeier M, Nair SK. Recombinant poliovirus for cancer immunotherapy. Annu. Rev. Med. 2018; 69: 289-299.
Nakamura S, Matsumoto T, Iida M, Yao T, Tsuneyoshi M. Primary gastrointestinal lymphoma in Japan: a clinicopathologic analysis of 455 patients with special reference to its time trends. Cancer 2003; 97: 2462-2473.
Dreyling M, Thieblemont C, Gallamini A et al. ESMO Consensus conferences: guidelines on malignant lymphoma. part 2: marginal zone lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma. Ann. Oncol. 2013; 24: 857-877.
Ruskone-Fourmestraux A, Fischbach W, Aleman BM et al. EGILS consensus report. Gastric extranodal marginal zone B-cell lymphoma of MALT. Gut 2011; 60: 747-758.
Chestovich PJ, Schiller G, Sasu S, Hiatt JR. Duodenal lymphoma: a rare and morbid tumor. Am. Surg. 2007; 73: 1057-1062.
Toshima M, Aikawa K, Soga K, Shibasaki K, Yoshida K, Emura I. Primary duodenal MALT lymphoma. Intern. Med. 1999; 38: 957-961.
Kim JS, Jung HC, Shin KH, Song IS, Kim CW, Kim CY. Eradication of Helicobacter pylori infection did not lead to cure of duodenal mucosa-associated lymphoid tissue lymphoma. Scand. J. Gastroenterol. 1999; 34: 215-218.
ASGE Standards of Practice Committee, Banerjee S, Cash BD et al. The role of endoscopy in the management of patients with peptic ulcer disease. Gastrointest. Endosc. 2010; 71: 663-668.