The importance of endoscopic ultrasonography in the management of low‐grade gastric mucosa‐associated lymphoid tissue lymphoma

• Published in: Alimentary pharmacology & therapeutics Vol. 16; no. 10; pp. 1715 - 1722
• Main Authors: Caletti, G., Zinzani, P. L., Fusaroli, P., Buscarini, E., Parente, F., Federici, T., Peyre, S., De Angelis, C., Bonanno, G., Togliani, T., Pileri, S., Tura, S.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.10.2002; Blackwell
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Biological and medical sciences; Disease-Free Survival; Drug Therapy, Combination - therapeutic use; Endosonography; Female; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; Helicobacter Infections - complications; Helicobacter Infections - drug therapy; Helicobacter pylori; Hematologic and hematopoietic diseases; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, B-Cell, Marginal Zone - diagnostic imaging; Lymphoma, B-Cell, Marginal Zone - microbiology; Lymphoma, B-Cell, Marginal Zone - pathology; Male; Medical sciences; Middle Aged; Neoplasm Staging; Stomach Neoplasms - diagnostic imaging; Stomach Neoplasms - microbiology; Stomach Neoplasms - pathology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors; Sonography; Human; Stomach; Prognosis; Spirillales; Treatment efficiency; Spirillaceae; Malignant hemopathy; Non Hodgkin lymphoma; Infection; Antibiotic; Chemotherapy; MALT lymphoma; Treatment; Helicobacter pylori; Lymphoproliferative syndrome; Low malignancy; Bacteriosis; Digestive diseases; Bacteria; Endoscopy; Mucosa disease; Antibacterial agent; Gastric disease
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1046/j.1365-2036.2002.01334.x

Summary Background : Anti‐Helicobacter pylori therapy has been reported to cause regression of low‐grade gastric mucosa‐associated lymphoid tissue lymphoma in a high percentage of patients. However, in some patients, these lesions persist despite antibiotic treatment. Aim : To determine the various endosonographic findings that may predict the regression of low‐grade gastric mucosa‐associated lymphoid tissue lymphoma post‐antibiotics. Methods : Seventy‐six patients with Helicobacter pylori‐positive gastric mucosa‐associated lymphoid tissue lymphoma were studied. Follow‐up data were available on 51 patients. All patients were treated with antibiotics. Participants underwent pre‐ and post‐anti‐Helicobacter pylori therapy endoscopy with gastric biopsies, followed by endoscopic ultrasonography examination of the stomach. Results : Helicobacter pylori was eradicated in 45 of 51 (88%) patients. At the 2‐year follow‐up, complete regression of mucosa‐associated lymphoid tissue lymphoma was seen in 28 of 51 (55%) patients: 12 of 16 (75%) patients in stage T1m N0, 11 of 19 (58%) patients in stage T1sm N0, four of eight (50%) patients in stages T1m N1 and T1sm N1, and one of four (25%) patients in stage T2 N0. None of the stage T2 N1 patients achieved clinical regression. Conclusions : Endoscopic ultrasonography evaluation of gastric mucosa‐associated lymphoid tissue lymphoma plays a pivotal role in the initial staging and post‐treatment follow‐up evaluation of these lesions. Accurate staging is essential in the determination of the optimal treatment modality.