Abstract
A 53-year-old woman visited a doctor and complained of chest discomfort after meals. Esophagogastroduodenoscopy showed multiple granular elevations in the gastric body. After biopsies from the elevations, she was diagnosed with mucosa-associated lymphoid tissue (MALT) lymphoma. Polymerase chain reaction also detected Helicobacter pylori and H. suis. Treatment to eradicate H. pylori and H. suis was successful. Endoscopic examination after the bacterial eradication treatment showed that multiple granular elevations remained in the gastric body; however, no lymphoma cells were found during histopathological examination. Thus, we reported a case of H. pylori-positive gastric MALT lymphoma with a unique morphology associated with H. suis superinfection.
Highlights
Mucosa-associated lymphoid tissue (MALT) lymphoma is a type of low-grade B-cell non-Hodgkin lymphoma
Helicobacter pylori is associated with the occurrence of gastric MALT lymphoma [1]; recent reports have associated non-H. pylori helicobacters (NHPH) with gastric MALT lymphoma
H. suis is a frequent cause of infection in cases of gastric MALT lymphoma with a nodular gastritis-like appearance [2]
Summary
Mucosa-associated lymphoid tissue (MALT) lymphoma is a type of low-grade B-cell non-Hodgkin lymphoma. We report a case of H. pylori-positive gastric MALT lymphoma with a unique morphology associated with H. suis superinfection. Esophagogastroduodenoscopy (EGD) showed multiple granular elevations in the gastric body. She was referred to our hospital for further examination. EGD showed closed-type atrophic changes in the background mucosa, with multiple granular elevations measuring 2–3 mm centered in the gastric body (Fig. 1a-c, e–g). Primary treatment involved 7-day bacterial eradication therapy using three oral agents: vonoprazan fumarate, amoxicillin hydrate, and clarithromycin Her stool tested negative for H. pylori antigen, and the bacterial eradication therapy was considered successful. Endoscopic images at 6 months after bacterial eradication showed that multiple granular elevations remained in the gastric body; the dilated blood vessels found in the surface layer had disappeared (Fig. 3a–c). Follow-up observation with regular endoscopic examination was planned to check for the recurrence of gastric MALT lymphoma or any changes in the form of the granular elevations
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