Treatment of low-grade gastric MALT lymphoma with Helicobacter pylori eradication – our results with long term follow-up

Background/aim. Lymphoma of mucosa associated lymphoid tissue (MALT lymphoma) of the stomach usually occurs as a consequence of Helicobacter pylori (H. pylori) infection. The aim of this study was to investigate the long-term effect of treatment of low-grade gastric MALT lymphoma with H. pylori eradication. Methods. In the period since 2002. to 2012. in 20 patients with dyspepsia, mean age 55.1 years, endoscopic and histologic diagnosis of gastric MALT lymphoma in the early stages were made. Histological preparations of endoscopic biopsy specimens were stained with hematoxyllin-eosin (HE), histochemical and immunohistochemical methods. Results. Endoscopic findings of gastritis was documented in 25% of patients, and 75% of patients had hypertrophic folds, severe mucosal hyperemia, fragility, nodularity, exulcerations and rigidity. Histopathologically, pathognomonic diagnostic criterion was the infiltration and destruction of glandular epithelium with neoplastic lymphoid cells, the so-called lymphoepithelial lesions. In all 20 patients H. pylori was verified by rapid urease test and Giemsa stain. After triple eradication therapy complete remission of MALT lymphoma was achieved in 85% of patients, with no recurrence of lymphoma and H. pylori infection in an average follow-up period of 48 months. In 3 (15%) patients, there was no remission of MALT lymphoma 12 months after eradication therapy. In two of these three patients had progression of MALT lymphoma to the diffuse large cell lymphoma. Conclusion. Durable complete remission of low-grade gastric MALT lymphoma achieved in a high percentage after the eradication of H. pylori infection. Thus preventing the formation of diffuse large cell lymphoma and gastric adenocarcinoma.