Mucosa-associated Lymphoid Tissue Lymphoma Research Articles

Proportion and characteristics of Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue lymphoma: A systematic review and meta-analysis.

While Helicobacter pylori (H. pylori) infection is common in patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma, there are still individuals who test negative for it. The proportion and characteristics of these patients remain unclear. We conducted a systematic search of the PubMed, Embase, and Cochrane Library databases for relevant articles. Using a random effects model, we performed a meta-analysis to assess the pooled proportion of gastric MALT lymphoma patients with negative H. pylori tests. Additionally, we compared characteristics between gastric MALT lymphoma patients with and without H. pylori infection to examine clinical features in H. pylori-negative cases. A total of 50 studies involving 6033 patients were included. The overall proportion of gastric MALT lymphoma patients with negative H. pylori tests was 20.5% (95% confidence interval: 17.0%-24.6%). This rate exhibited an increasing trend over the years, particularly in non-Asian countries and in studies published after 2013, as well as in cases with sample sizes exceeding 100 participants, in male individuals, and among those with proximal or multiple lesions, non-superficial type morphology, submucosal invasion, and advanced clinical staging. Compared to H. pylori-positive patients, those who tested negative were more likely to be male, have proximal lesions, exhibit submucosal invasion, and present with an advanced clinical stage. This study provides comprehensive information on the proportion and characteristics of H. pylori-negative gastric MALT lymphoma cases, highlighting the need for future clinical attention to treatment and surveillance in this patient population.

Association between Helicobacter pylori infection and gastric adenocarcinoma: a retrospective and comparative analysis

The Helicobacter pylori infection increases the risk of development gastric neoplasia. This is the most important risk factor for causing intestinal adenocarcinoma, which is the most prevalent gastric cancer, and is also strongly associated with mucosa-associated lymphoid tissue lymphoma - MALT. A retrospective and comparative analysis was carried out at Hospital de Amor de Barretos, a reference oncology service, in the years 2017 and 2021, in order to determine whether there is an association between the existence of the infection and gastric adenocarcinoma, and whether there was any change over 05 years. In total, 369 medical records of patients diagnosed with gastric cancer were analyzed, 218 and 151, respectively. In 2017, 45.1% of patients were investigated for Helicobacter pylori and 54% in 2021 (p=0.104). Infection was detected in 42.3 and 33.3% (p=0.232) respectively, and eradication therapy in 19.5 and 24%. Although the present study was carried out in a referral oncology hospital, it was not possible to objectively determine the relationship between Helicobacter pylori infection and the development of gastric adenocarcinoma.

Plukenetia volubilis leaves as source of anti-Helicobacter pylori agents

IntroductionHelicobacter pylori infection is a major issue worldwide, with widespread prevalence, combined with its link to gastritis, peptic ulcers, gastric cancer, and mucosa-associated lymphoid tissue (MALT) lymphoma. Meanwhile, effectiveness of current treatment protocols is limited by increasing antibiotic resistance and patient compliance issues due to long regimens and side effects. Plukenetia volubilis, or sacha inchi, is a valuable source of bioactive molecules. However, studies on its antimicrobial activity, especially against H. pylori, are lacking.MethodsIn this study, the anti-H. pylori activity of P. volubilis leaves water extract was explored using in vitro and in silico approaches. High-Performance Liquid Chromatography coupled to Electrospray Ionisation and Quadrupole Time-of-Flight Mass Spectrometry (HPLC-ESI- QTOF-MS-MS) analysis of the water extract from the leaves was used to characterise the chemical composition of the plant and allowed identification of some flavonoids, such as astragalin, and some phenolic compounds. Then, high-speed counter current chromatography (HSCCC) was used to fractionate the ethyl acetate partition obtained from the water extract from the leaves.Results and DiscussionThe presence of flavonoids derived from kaempferol was confirmed and astragalin was isolated for the first time in P. volubilis. The P. volubilis water infusion, ethyl acetate extract and the isolated astragalin exhibited anti-bacterial activity against H. pylori J99 and two clinical isolates (e.g., minimum inhibitory concentrations of 0.53, 0.51 and 0.49 μg/mL, respectively, for clarithromycin-resistant clinical isolate SSR366). Then, using molecular docking for potential protein targets for H. pylori, it was verified that astragalin could interact with these proteins by in silico analysis.ConclusionThese findings highlight that P. volubilis and astragalin produce a bacteriostatic activity against H. pylori and may have potential to be used in treatment against H. pylori, after further research.

Clonal Bronchopulmonary B-Cell Proliferations of Indeterminate Malignant Potential in Patients with Common Variable Immune Deficiency (CVID) associated Granulomatous Lymphocytic Interstitial Lung Disease (GLILD)

Abstract Introduction/Objective Pulmonary extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) is often challenging to distinguish from reactive nodular lymphoid hyperplasia, and assessing B-cell clonality in such cases is crucial in making the distinction. However, patients with common variable immune deficiency (CVID) can harbor clonal or oligoclonal lymphoid populations in their tissues, particularly in association with granulomatous lymphocytic interstitial lung disease (GLILD), making the distinction from MALT lymphoma extremely challenging. We report six cases of GLILD with clonal or oligoclonal B cell infiltrates in lung wedge resection specimens and describe their clinicopathologic characteristics, management, and outcomes. Methods/Case Report A retrospective review was performed to collect lung wedge resection specimens from patients with CVID showing atypical B-cell infiltrates associated with GLILD between 01/2015 and 08/2023. The clinicopathologic findings, management, and response to treatment were studied. Results (if a Case Study enter NA) A total of six GLILD cases were identified with variable degrees of architectural and cytologic lymphoid atypia. Clonality of the lymphoid infiltrate was assessed by kappa/lambda in situ hybridization staining in all six, flow cytometry in 3/6, and IGH gene rearrangement in 4/6 cases. The infiltrate showed frank lambda restriction in 1/6, lambda predominance in 1/6, polytypic expression in 1/6, and no significant plasmacytic component in 3/6 cases. Flow cytometry detected atypical light chain skewed B-cell populations in 3/3 of cases. IGH was positive for clonality in 3/4 and oligoclonal in 1/4 cases. Four patients received therapeutic intervention for GLILD, including one with Rituximab monotherapy, two with Rituximab+Azathioprine, and one with Rituximab+Mycophenolate leading to marked symptomatic and radiologic improvement in all four patients. The remaining two patients were observed to have stable disease. Conclusion Patients with CVID can harbor clonal B-cell populations due to their underlying immune dysfunction. Studies have shown that these can be transient and may not always progress to overt lymphoma. In the setting of GLILD, detecting these populations makes the distinction from MALT lymphoma very challenging. Given that the first- line therapy for both GLILD and MALT is anti-CD20 therapy, the malignant potential of these clones remains uncertain and can only be determined with long-term clinical follow-up.

Crystal-Storing Histiocytosis of the Stomach

Abstract Introduction/Objective Crystal-storing histiocytosis (CSH) is an infrequently seen lesion comprised of eosinophilic histiocytes filled with refractile crystalline structures that most often have been characterized as IgG kappa restricted monoclonal immunoglobulins. The etiology for the mechanism of accumulation of the immunoglobulins is incompletely elucidated but numerous mechanisms have been postulated, including overproduction, faulty secretion, and impaired breakdown. Though CSH itself is a benign lesion, it has repeatedly been noted to be a harbinger of a concurrent or developing lymphoproliferative disorder. Literature review revealed a wide age range of presentations with no gender predilection and reports of this lesion occurring most commonly in the bone, kidneys, lungs, lymph nodes, and head and neck region. The gastrointestinal tract is uncommonly involved, with the stomach being the most frequently cited location. Reports of CSH in this setting have noted simultaneous infections with Helicobacter pylori and a range of associated lymphomas. Methods/Case Report We report a lesion from the stomach of a 45 year old female endoscopically described as containing patchy atrophic and nodular mucosa that was biopsied for gastric mapping in a patient with a reported history of autoimmune atrophic gastritis but without confirmatory antibodies on serology. Immunohistochemical stains highlighted a CD68 positive, smooth muscle myosin and cytokeratin negative, population of cells with cytoplasmic kappa positivity. CSH was diagnosed in a background of chronic inactive gastritis of both the antrum and fundus without evidence of H. pylori via staining or associated extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue on biopsy. Recent imaging revealed no concerning lymphadenopathy, lytic lesions, or masses. Results (if a Case Study enter NA) NA Conclusion Increasing pathologists’ awareness of this entity and its potential to be a paraneoplastic lesion is crucial, as further work-up is needed to exclude an underlying hematolymphoid neoplastic process.

Early gastric composite tumor comprising signet-ring cell carcinoma and mucosa-associated lymphoid tissue lymphoma: A case report

BACKGROUND Composite tumors are neoplasms comprising two distinct, yet intermingling, cell populations. This paper reports a rare phenomenon where early gastric signet-ring cell carcinoma (SRCC) and gastric mucosa-associated lymphoid tissue (MALT) lymphoma coexist within the same lesion. CASE SUMMARY A 40-year-old woman presented to the West China Hospital for examination, which revealed a whitish, shallow, and uneven mucosal lesion in the stomach. The lesion was diagnosed as a poorly differentiated adenocarcinoma, including SRCC with atypical lymphoid hyperplasia associated with Helicobacter pylori infection, based on histopathological examination of the biopsy specimen. The lesion was excised using segmental gastrectomy. However, histological examination of the surgical specimen confirmed that it was a poorly differentiated gastric adenocarcinoma with features of SRCC and MALT lymphoma. These two entities were stage I and coexisted in the same lesion. CONCLUSION It is uncommon for gastric SRCC and MALT lymphoma to coexist without distinct borders. Surgical resection is effective for these lesions.

Primary lymphoma of mucosa associated lymphoid tissue (MALT lymphoma) in the urinary bladder mimicking recurrent urinary tract infection: a case report and literature review

We report the case of a 79-year-old woman with primary lymphoma of mucosa-associated lymphoid tissue (MALT) in the urinary bladder. The patient, with urinary frequency, urgency and suprapubic pain had several emergency room visits due to recurrent urinary tract infection. Both sonogram and cystoscopy identified bladder tumors near the bladder neck. An abdominal contrast-enhanced computed tomography scan revealed a polypoid lesion on the anterior bladder wall without enlarged lymph nodes. Transurethral resection of the bladder tumor was conducted. The pathology report confirmed extranodal marginal zone MALT lymphoma. The clinical stage was IEA. Follow-up imaging reported residual bladder tumors, prompting adjuvant radiotherapy. The patient was treated successfully and was disease-free at the 9-month follow-up visit. Primary lymphoma is an uncommon pathological subtype. Its clinical and radiological differentiation from urothelial carcinoma (UC) can be challenging, but treatment strategies differ significantly. A definitive diagnosis relies on histopathology and immunohistochemistry. Typically, bladder lymphoma has a favorable prognosis, but further research is required to identify the optimal treatment.

Linfoma não Hodgkin da Zona Marginal Extranodal Tipo MALT com Acometimento da Coluna Torácica: revisão Sistemática da Literatura e Relato de Caso em um Hospital Universitário no Brasil

Background: Primary bone lymphomas are rare, accounting for less than 1% of non-Hodgkin's lymphomas (NHL). Extranodal marginal zone non-Hodgkin lymphoma of mucosa-associated lymphoid tissue (MALT) arising in the vertebral spine is extremely rare, with only seven cases reported. Methodology: A systematic literature review was conducted on cases from 2012 to 2022 of extranodal marginal zone MALT lymphoma involving the vertebral spine and associated with spinal cord compression. Additionally, a case report from a university hospital in Rio de Janeiro is described. The study was approved by the Research Ethics Committee (approval number: 5.818.416). Searches were performed in SciELO, PubMed, and LILACS databases, using the Health Sciences Descriptors: ("Vertebral Body" OR Spine) AND ("Lymphoma B-Cell Marginal Zone" OR "MALT Lymphoma" OR "Lymphoma of Mucosa Associated Lymphoid Tissue" OR "Mucosa Associated Lymphoid Tissue Lymphoma"). Articles with full texts available in English or Portuguese were selected. Case Description: A 56-year-old female presented with right-sided back pain, progressing to right flank irradiation, lower limb weakness (LLLL), and constitutional symptoms. MRI revealed a solid extradural mass occupying two-thirds of the vertebral canal's diameter, displacing and compressing the dorsal cord to the left. A bone marrow biopsy confirmed infiltration. Laminectomy was performed, and histopathology identified stage IVB extranodal marginal zone MALT lymphoma. Adjuvant chemotherapy led to complete remission. Results and Discussion: The literature review uncovered two relevant case reports. The thoracic spine was the most commonly affected region, and LLLL weakness was the most frequent symptom, with normal laboratory results. Treatment typically involved surgical tumor removal combined with radiotherapy or chemotherapy. Recurrence occurred in both cases, but follow-up showed no evidence of disease. The clinical presentation and exam findings of the current patient were similar to those in the literature, though with bone marrow infiltration. Treatment was consistent with cases in the review, with no recurrence to date. Conclusion: This case represents an uncommon manifestation of primary extranodal marginal zone MALT lymphoma with spinal cord compression, distinguished by bone marrow infiltration—a feature not previously reported in the two cases found in the literature. The case may be considered within the same group of cases reviewed.

Long-Term Clinical Efficacy of Radiotherapy for Patients with Stage I-II Gastric Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue: A Retrospective Multi-Institutional Study.

To evaluate long-term treatment outcomes in patients with localized gastric mucosa-associated lymphoid tissue (MALT) lymphoma treated with radiation therapy (RT). A total of 229 patients who received RT in ten tertiary hospitals between 2010 and 2019 were included in this multi-center analysis. Response after RT was based on esophagogastroduodenoscopy after RT. Locoregional relapse-free survival (LRFS) and disease-free survival (DFS) were evaluated. After a median follow-up time of 93.2 months, 5-year LRFS, DFS, and OS rates were 92.8%, 90.4%, and 96.1%, respectively. LRFS, DFS, and OS rates at 10 years were 90.3%, 87.7%, and 92.8%, respectively. Of 229 patients, 228 (99.6%) patients achieved complete remission after RT. Five-year LRFS was significantly lower in patients with stage IIE than in those with stage IE (77.4% vs. 94.2%, p=0.047). Patients with age ≥ 60 had significantly lower LRFS than patients with age < 60 (89.3% vs. 95.1%, p=0.003). In the multivariate analysis, old age (≥ 60 years) was a prognostic factor for LRFS [hazard ratio (HR) of 3.72 and confidence interval (CI), 1.38-10.03; p=0.009). Grade 2 or higher gastritis was reported in 69 (30.1%) patients. Secondary malignancies including gastric adenocarcinoma, malignant lymphoma, lung cancer, breast cancer, and prostate cancer were observed in 11 (4.8%) patients after RT. Patients treated with RT for localized gastric MALT lymphoma showed favorable 10-year outcomes. Radiation therapy is an effective treatment without an increased risk of secondary cancer. The toxicity for radiotherapy to the stomach is not high.

S2876 An Extremely Rare Case of Extra-Nodal Marginal Zone B-Cell Lymphoma in Transverse Colon Found During Screening Colonoscopy in an Asymptomatic Patient

S2876 An Extremely Rare Case of Extra-Nodal Marginal Zone B-Cell Lymphoma in Transverse Colon Found During Screening Colonoscopy in an Asymptomatic Patient

S3881 Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue of the Stomach and Small Intestine Mimicking Crohn’s Disease With Suspected Transformation to Diffuse Large B-Cell Lymphoma

S3881 Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue of the Stomach and Small Intestine Mimicking Crohn’s Disease With Suspected Transformation to Diffuse Large B-Cell Lymphoma

Reduced-dose radiotherapy for stage IE gastric mucosa-associated lymphoid tissue lymphoma: a multi-institutional prospective study (KROG 16–18)

PurposeDefinitive radiotherapy (RT) of 30 Gy or higher is commonly recommended to treat Helicobacter pylori-independent gastric mucosa-associated lymphoid tissue (MALT) lymphoma with an excellent disease control rate. However, the efficacy of reduced-dose RT has not yet been evaluated in a prospective cohort study. This multi-institutional study aimed to determine the role of reduced-dose RT in the treatment of stage IE gastric MALT lymphoma. MethodsBetween March 2017 and June 2022, 62 patients with histologically confirmed stage IE gastric MALT lymphoma without evidence of H. pylori infection were enrolled. The patients were treated with reduced-dose RT at a total dose of 24–25.5 Gy to the entire stomach. The response to therapy was evaluated by endoscopy with a biopsy of suspicious lesions if necessary. The primary endpoints were 6-month complete remission (CR) and local failure-free survival (LFFS). ResultsAmong 62 patients, 32 (51.6%) were previously treated for H. pylori eradication. Radiotherapy was delivered using 3D-conformal (n=20, 32.3%) or intensity-modulated radiotherapy (n=42, 67.7%). The median follow-up duration was 34.5 months (range, 9.6–68.8 months). The 6-month CR rate was 96.7%. The 5-year LFFS and progression-free survival rates were 92.0% and 90.4%, respectively. None of the patients experienced grade 3 or worse acute toxicities, and grade 2 acute toxicities were reported in 17 patients (27.4%). ConclusionReduced-dose RT exhibited excellent response rates in stage IE gastric MALT lymphoma, comparable to historical controls of standard dose (≥ 30 Gy) radiotherapy, with a minimal toxicity profile. Current prospective evidence strongly supports the use of definitive radiotherapy (24–25.5 Gy) for the treatment of H. pylori-independent stage IE gastric MALT lymphoma.

Long-term Outcomes and Prognostic Factors of Gastric MALT Lymphoma.

This study aimed to evaluate the long-term prognosis of patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma, including overall survival (OS), remission, and factors associated with an aggressive disease course. Medical records of 153 patients diagnosed with gastric MALT lymphoma between 2013 and 2020 were retrospectively reviewed. Patients experiencing relapse, progression, high-grade transformation, or residual diseasewere included in the aggressive group and were compared with those in the indolent group. Additionally, the endoscopic findings of Helicobacter pylori-negative patients were reviewed. Patient characteristics were as follows: mean age (56.9±11.2 years), sex (male, 51.0%), H. pylori infection (positive, 79.7%), endoscopic location (distal, 89.5%), endoscopic feature (superficial, 89.5%), clinical stage (stage I, 92.8%), invasion depth by endoscopic ultrasound (mucosa, n=115, 75.7%), and bone marrow result (no involvement, n=77, 100.0%). The median follow-up period was 59 months (mean, 61; range, 36-124) and the continuous remission period (n=149) was 51 months (mean, 50; range, 3-112). The 5-year survival rate was 97.7% while the 5-year continuous remission was 88.3%. Factors associated with the patients in the aggressive group were old age, sex(male), and clinical stage II or higher. H. pylori-negative patients' endoscopy revealed a high incidence of atrophic gastritis in the antrum. The long-term prognosis of gastric MALT lymphoma appears indolent and is indicated by the 5-year OS and continuous remission rates. Aggressive disease courses are associated with old age, sex (male), and clinical stage II or higher, but are not related to OS.

S3029 Incidental Finding of Mucosa-Associated Lymphoid Tissue Lymphoma on Screening Colonoscopy

S3029 Incidental Finding of Mucosa-Associated Lymphoid Tissue Lymphoma on Screening Colonoscopy

Detection, isolation and virulence characterization of Helicobacter suis from pork products aimed to human consumption

Helicobacter suis is the most common non-H. pylori gastric Helicobacter species found in humans. Infection is associated with gastritis, peptic ulcer, gastric MALT lymphoma and neurodegenerative disorders, particularly Parkinson's disease. However, the pathogenicity of this species is still a matter of research, and results of virulence studies and antibiotic susceptibility tests tend to vary between strains. Cholesterol α-glucosyltransferase (αCgT), a known H. pylori virulence factor, appears to be present in most clinical H. suis isolates. The ability to form biofilms also plays a crucial role in the pathogenesis of H. pylori. However, no reports have been published on this ability in H. suis.H. suis is considered an emerging zoonotic pathogen, with pigs being the main source of human infection. However, there is very little information on its presence in pork, mainly due to the difficulties of its culture. Therefore, our aim was to determine the prevalence of H. suis in pork products from our geographical area by PCR and fluorescence in situ hybridisation (FISH), as well as to isolate the bacteria and determine the antibiotic susceptibility patterns, the presence of the αCGT gene and the ability of the isolates to form biofilms.Overall, H. suis was detected in 20 of the 70 (28.6 %) samples analyzed. In 3 of them, H. suis was isolated. The αCGT gene was detected in all isolates and two of them showed a multiresistance pattern. The H. suis reference strain and two of the isolates showed “strong” to “moderate” in vitro biofilm formation ability under optimal growth conditions.Our results seem to indicate that H. suis is significantly prevalent in pork products. The combination of culture with FISH and/or mPCR proved to be a rapid and specific method for the detection, identification and direct visualization of cultivable H. suis cells from pork food products.

S3350 Successful Endoscopic Mucosal Resection of Primary Esophageal MALT Lymphoma and Subsequent Surveillance

S3350 Successful Endoscopic Mucosal Resection of Primary Esophageal MALT Lymphoma and Subsequent Surveillance

A single-cell atlas of MALT lymphomas complicating Sjögren's syndrome

A single-cell atlas of MALT lymphomas complicating Sjögren's syndrome

S2313 Helicobacter pylori-Negative MALT Lymphoma Presenting With Severe Gastrointestinal Bleeding: Insights from a Systematic Review of Published Case Reports

S2313 Helicobacter pylori-Negative MALT Lymphoma Presenting With Severe Gastrointestinal Bleeding: Insights from a Systematic Review of Published Case Reports

S4038 Novel Use of Full Thickness Resection Device to Ensure Complete Resection of Colonic MALT Lymphoma Post-Endoscopic Mucosal Resection

S4038 Novel Use of Full Thickness Resection Device to Ensure Complete Resection of Colonic MALT Lymphoma Post-Endoscopic Mucosal Resection

S5040 Resistant MALT Lymphoma After Eradication of Helicobacter pylori in a 31-year-old Hispanic Female: A Case Report

S5040 Resistant MALT Lymphoma After Eradication of Helicobacter pylori in a 31-year-old Hispanic Female: A Case Report