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
Personal Characteristics
6 -year-old male was diagnosed with adrenoleukodystrophy at age 5 and underwent cord blood transplantation, after the transplantation was administered oral immunosuppressants
Clinical Characteristics
Referred due to complaint of nausea with hematochezia upper gi endoscopy revealed an ulcerated lesion in the anterior wall of the upper corpus of the stomach, and the mass was diagnosed as a low-grade gastric lymphoma of the malt type associated with h. Pylori gastritis (based on biopsy specimen) local invasion nor ln involvement were present when immunosuppressants were tapered, he was also treated with a proton pump inhibitor combined with clarithromycin and amoxicillin for the h. Pylori
Remission Characteristics
Treatment eradicate the h. Pylori and also brought the malt lesion to complete remission 3 year follow up, the patient remains well without any sign of relapse
Treatment & Mechanisms
Proposed Remission Mechanisms
H. Pylori eradication
Clinical Treatment
Methylprednisolone and fk506 after cord blood transplantation at age 5 proton pump inhibitor combined with clarithromycin and amoxicillin for h. Pylori
Non-Clinical Treatment
None reported