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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

61-year-old man

Clinical Characteristics

Complaining of abdominal pain. Physical examination did not reveal any peripheral lymphadenopathy. Upper gastrointestinal endoscopy, on june 30, 2003, revealed a protuberant tumor with a shallow, white-coated, saucer-like ulceration on the greater curvature of the angulus. Biopsy specimens from the tumor showed the diffuse proliferation of large, atypical lymphoid cells, with irregular, oval vesicular nuclei and scanty cytoplasm. The patient was confirmed to be positive for h. Pylori infection. The tumor was diagnosed as a primary gastric dlbl at stage i

Remission Characteristics

Upper endoscopy was performed again to assess the lesion, on september 11, 2003, at which time the finding had changed, mimicking a benign peptic ulcer scar with fold convergency. Biopsy specimens revealed no lymphoma cells.

Treatment & Mechanisms

Proposed Remission Mechanisms

H2ra administration

Clinical Treatment

Roxatidine