Rapid Resolution of a Gastric Lymphoma with Helicobacter Eradication Therapy

As one of the most prevalent chronic bacterial infections, Helicobacter pylori has had a uniquely significant impact on human pathology. Infection with H. pylori has been shown to be involved in a wide array of gastrointestinal diseases, from peptic ulcer disease to gastric malignancy. Here, we present an 82 year-old patient who was found to have a large ulcerated gastric mass, along with a concomitant H. pylori infection.  Gastric biopsies later revealed a gastric MALT (mucosa-associated lymphoid tissue) lymphoma, suspicious of transformation to a high-grade diffuse large B-cell lymphoma. Primary treatment with Helicobacter eradication therapy resulted, remarkably, in complete endoscopic and histologic resolution of the lymphoma only three weeks after the completion of triple therapy. Through this illustrative case, we review the controversies in the management of high-grade gastric lymphoma, as well as the clinical practice surrounding endoscopic surveillance for malignancy follow-up.