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Spontaneous Remission Of Primary Diffuse Large B-cell Gastric Lymphoma.

Watari, J. 2005Stomach cancer

Watari, J., Saitoh, Y., Fujiya, M., Nakamura, K., Inaba, Y., Okamoto, K., Tanabe, H., Yasuda, A., Miyokawa, N., & Kohgo, Y. (2005). spontaneous remission of primary diffuse large B-cell gastric lymphoma. Journal of gastroenterology, 40(4), 414–420. https://doi.org/10.1007/s00535-004-1561-0

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Abstract

Spontaneous and complete disappearance of diffuse large B-cell lymphoma (DLBL) of the stomach is extremely rare. Although regression of gastric DLBL after eradication of Helicobacter pylori has recently been reported, we present two consecutive cases of stage I DLBL of the stomach which disappeared after only nonspecific therapy, including histamine 2-receptor antagonist (H2RA); both cases were documented histologically and endoscopically. Both patients were positive for H. pylori, and later received H. pylori eradication therapy. The disease has not recurred after 11 and 6 months, respectively. Our cases suggest that the option of combination therapy with H2RA either with or followed by H. pylori eradication is appropriate for consideration as an initial approach in standard therapy for stage I diffuse large B-cell gastric lymphoma.

Case Details

Disease Location

Stomach

Personal Characteristics

60-year-old woman

Clinical Characteristics

1- months history of preprandial abdominal pain. Upper gastrointestinal endoscopy at the hospital, done on june 3, 2002, revealed multiple erosions and ulcers, with irregular and protruding margins and measuring 1 to 2 cm in size, from the angulus to the antrum. Eus showed diffuse hypoechoic thickening in the second layer of the gastric wall infiltrating into the third layer. Malignant lymphoma cells were obtained from the biopsy specimens in this examination, and h. Pylori was positive

Remission Characteristics

On september 5, endoscopic findings showed improvement since the previous examination, with complete disappearance of the tumor, seen by endoscopy on october 7. Lymphoma cells had disappeared in several biopsy specimens obtained on february 13, 2003

Treatment & Mechanisms

Proposed Remission Mechanisms

H2ra administration

Clinical Treatment

Ranitidine lansoprazole, amoxicillin, and clarithromycin per day for the eradication of h. Pylori.