Deep infiltrative low-grade MALT (mucosal-associated lymphoid tissue) colonic lymphomas that regressed as a result of antibiotic administration: Endoscopic ultrasound evaluation

Department of Gastroenterology, Fukuoka University Chikushi Hospital, 377-1 Ohaza Zokumyoin, Chikushino, 818-5807, Japan.
Journal of Gastroenterology (Impact Factor: 4.52). 09/2005; 40(8):843-7. DOI: 10.1007/s00535-005-1639-3
Source: PubMed


Since 1997 we have experienced three cases of low-grade colonic mucosal-associated lymphoid tissue (MALT) lymphomas. The depth of tumor invasion was evaluated by endoscopic ultrasonography (EUS) and the mass lesions were all diagnosed as having extended beyond the deep region of the submucosal layer. Although all of these patients tested negative for gastric Helicobacter pylori, their tumor lesions regressed after antibiotic treatment in accordance with H. pylori eradication therapy. In general, consensus has been reached regarding antibiotic therapy for gastric MALT lymphomas. However, as a prerequisite for antibiotic therapy, the therapy has been deemed effective against these gastric tumors if the extent of infiltration, as evaluated by EUS, is limited to the mucosal layer or the superficial region of the submucosal layer. Based on the therapeutic outcomes seen in the three patients studied here, it is suggested that antibiotic therapy might be useful in treating MALT lymphomas of the colon, even in patients with advanced invasive tumors, in contrast to the extent of the lesions in the stomach suitable for antibiotic treatment. The success of the antibiotic treatment also suggests that MALT lymphomas may be caused by unknown luminal microorganisms, other than H. pylori.

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    • "H. pylori bacteria do not exist in the large intestine, therefore the relationship remains unclear. Moreover, in several cases, the lesions regressed after the single administration of an antibiotic [7]. API2-MALT1 fused gene positive cases of gastric MALT lymphoma are resistant to H. pylori eradication. "

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    ABSTRACT: Infection with Helicobacter pylori is common. Over 50% of the world's population is estimated to be colonized with the bacteria. The association between Helicobacter pylori and gastric mucosa-associated lymphoid tissue (MALT) lymphoma is well documented. Anti-Helicobacter pylori treatment and the successful eradication of the bacteria can potentially cure patients who test positive for the bacteria and who are diagnosed with low-grade gastric MALT lymphoma. The purpose of this article is to review the evidence implicating Helicobacter pylori as a causal pathogen for the development of gastric MALT lymphoma and to determine that anti-Helicobacter pylori therapy is an effective first-line treatment. The clinical presentation, endoscopic findings, diagnosis, staging, treatment, and follow-up of patients with gastric MALT lymphoma who are treated with anti-Helicobacter pylori therapy are also discussed.
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