BCL10 aberations and NF-kappa B activation involving p65 are absent or rare in primary gastric MALT lymphoma

ABSTRACT Introduction: Mucosa Associated Lymphoid Tissue (MALT) lymphoma accounts for 5-17% non-Hodgkin lymphomas (NHL). The molecular pathogenesis of MALT lymphomas is not well established. The aim of this study was to evaluate immunohistochemically determined nuclear coexpression of BCL10 and NF-kappaB (NF-kB) in tumor cells of gastric MALT lymphoma and its impact on the patogenesis and outcome of the disease. Methods: Medical records of 35 patients with newly diagnosed gastric MALT lymphoma were analyzed and biopsy specimens were immunostained for BCL10 and NF-kB expression (p65 subunit). Results: Median age of 35 patients diagnosed with gastric MALT lymphoma was 63.5 years  (male/female=21/14). B symptoms were present in 23/35 (65.7%) patients with the weight loss as the most common symptom. Gastric MALT lymphomas were usually localized in the stomach corpus and corpus and antrum (45.7% and 31.2% respectively). H. pylori infection was confirmed in 20 out of 30 patients (66.7%). Treatment options were as follows: immunochemotherapy in 10 patients (28.5%), surgery in 9 patients (25.8%), combined surgery and chemotherapy in 14 patients (40%) and supportive measures in 2 patients (5.7%). Complete remission was achieved in 13 (37.1%) patients and partial remission in two patients (5.7%). Sixteen patients (45.7%) had disease progression (p<0.001). Cytoplasmatic expression of BCL10 in tumor cells was detected in 19(54.3%) specimens.. Nuclear expression was not detected in any specimen. Cytoplasmic expression of NF-kB was present in 22 (65.7%) specimens, but nuclear expression was not detected in any speciment. Conclusion : Nuclear expressions (activation) of the p65 subunit of NF-kB and BCL10 were not detected in specimens of gastric MALT lymphoma. The correlation of nuclear coexpression of BCL10 and NF-kB in gastric MALT lymphoma was not established. These results indicate that other mechanisms and signal pathways are active in lymphogenesis of gastric MALT lymphoma, as that apoptotic inhibition is not the main and only mechanism in tumorogenesis.