Gastric MALT lymphoma: Anatomo-clinical data and outcome of early stage H. pylori-associated gastric MALT-lymphoma resistant to treatment

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Published Dec 20, 2011
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Vol. 89 No. (2011): Issue Dec 2011

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Ines Chelly
Olfa Adouni
Sofiane Chouaib
Haifa Azouz
Haifa Nfoussi
Slim Haouet
Moncef Zitouna
Nidhameddine Kchir

Abstract

Aim: To describe the clinical, endoscopic and histological particularities of early stage HP associated gastric MALT lymphoma resistant to anti Hp treatment and identify predicting factors of resistance.
Methods: We retrospectively studied 12 patients with primary low grade gastric localized MALT lymphoma treated with anti HP treatment and diagnosed at La Rabta Hospital from 1999 to 2009.
Results: The ultrasonography was normal in 5 patients between the 6 responding patients. Perigastric lymph nodes were found in non responders (33.3%). Hp eradication was achieved in 66% of patients not responding while Hp was eradicated in 100% of responders. The two non-responding patients with failure of eradication of Hp had a strain resistant to Clarithromycin Hp.
Conclusion: Predicting factors of failure of anti HP: HP resistance to antibiotics, the proximal head, and the presence of perigastric lymph nodes. Recently, chromosomal aberrations and immune-histochemical markers have been implicated as factors of non response to anti Hp.

Keywords:

Lymphoma of mucosa-associated lymphoid tissue, stomach, Helicobacter pylori, immunohistochemistry, therapy.

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