Remission Of Primary Low-grade Gastric Lymphomas Of The Mucosa-associated Lymphoid Tissue Type In Immunocompromised Pediatric Patients
Ohno, Y., Kosaka, T., Muraoka, I., Kanematsu, T., Tsuru, A., Kinoshita, E., & Moriuchi, H. (2006). Remission of primary low-grade gastric lymphomas of the mucosa-associated lymphoid tissue type in immunocompromised pediatric patients. World journal of gastroenterology, 12(16), 2625–2628. https://doi.org/10.3748/wjg.v12.i16.2625
View Original Source →Abstract
We report the remission of primary gastric lymphoma of the mucosa-associated lymphoid tissue (MALT) type in two immunocompromised pediatric patients. Patient 1, a 14-year-old boy in an immunocompromised state of unknown cause, complained of repeated abdominal pain. Examinations revealed gastric MALT with local invasion and lymph node involvement. Serum anti-Helicobacter pylori (H pylori) antibody was positive. H pylori eradication was abandoned due to its adverse effects. The MALT lesion spontaneously regressed over the next 24 months without any treatment for lymphoma. Patient 2, a 6-year-old boy, underwent cord blood transplantation for the treatment of adrenoleukodystrophy. He was administered immunosuppressants for graft-versus-host disease after transplantation. Nausea and hematochezia appeared and further examinations revealed gastric MALT with H pylori gastritis. Treatment consisting of medication for the H pylori infection alone eradicated the H pylori and completely resolved the patient’s MALT lesion, as well. Patients 1 and 2 were followed up over periods of 10 years and 3 years, respectively, without any signs of relapse. In conclusion, gastric lymphoma of the MALT type can be cured by conservative treatment even in immunocompromised pediatric patients.
Case Details
Disease Location
Stomach with duodenum invasion
Personal Characteristics
14 -year-old male history of autoimmune hemolytic anemia at 1 -year-old, and a measles infection at 2 -year-old he developed systemic lymphadenopathy and hyper-gamma-globulinemia and was administered oral prednine from the age of 5 onward based on a putative diagnosis of immunoblastic lymphadenopathy
Clinical Characteristics
Upper gi endoscopy performed due to repeated abdominal pain revealed a tumor-like lesion in the stomach leading to referral a tender, hen-egg-sized mass was found in the epigastrium, endoscopy revealed a polypoid lesion in the posterior wall of the lower corpus of the stomach the mass was diagnosed as a low-grade gastric lymphoma of the malt type based on biopsy specimen exam the biopsy also confirmed an invasion to the duodenum CT and gallium scintigraphy strongly suggested metastases to the para-aortic lymph nodes fear of invasion, wait-and-see was adopted because the patient was immunocompromised serum was positive for anti-h. Pylori antibody but eradication was abandoned due to adverse effects
Remission Characteristics
Over the next 24 months the malt lesion regressed spontaneously and abdominal pain gradually disappeared 10 year follow-up confirmed regression with no signs of relapse and health remains well
Treatment & Mechanisms
Proposed Remission Mechanisms
No major mechanism proposed
Clinical Treatment
Oral prednine since age 5 (no mention of dosage changes)
Non-Clinical Treatment
None reported