Open AccessH. pylori negative gastric MALT lymphoma with API2-MALT1 translocation treated by endoscopic submucosal dissection
Author(s) -
Tomomitsu Tahara,
Noriyuki Horiguchi,
Tsuyoshi Terada,
Dai Yoshida,
Masaaki Okubo,
Kohei Funasaka,
Yoshihito Nakagawa,
Tomoyuki Shibata,
Naoki Ohmiya
Publication year - 2021
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000024371
Subject(s) - medicine , esophagogastroduodenoscopy , malt lymphoma , endoscopic ultrasound , helicobacter pylori , biopsy , pathology , lymphoma , endoscopic mucosal resection , lamina propria , lesion , stomach , gastric mucosa , gastric lymphoma , lymphatic system , gastroenterology , endoscopy , radiology , epithelium
Rationale: API2-MALT1 positive gastric mucosa-associated lymphoid tissue (MALT) lymphomas are considered to have favorable prognosis. We report a case of API2-MALT1 positive gastric MALT lymphoma, treated by endoscopic submucosal dissection (ESD). Patient concerns: A 51-year-old man underwent esophagogastroduodenoscopy (EGD) for the annual health checkup examination. Diagnoses: The EGD showed a reddish depressed lesion with small reddish spots in the lower gastric body. There was no endoscopic atrophy in the entire stomach and Helicobacter pylori ( H. pylori ) serum test was negative. Infiltration of small lymphocytes was shown in the gastric tissues obtained by the endoscopic biopsy. The fluorescence in situ hybridization using the biopsy samples confirmed the presence of genetic translocation of API2-MALT1, suggesting that the lesion is API2-MALT1 positive MALT lymphoma. Interventions: Since endoscopic ultrasound suggested that the lesion was localized within the lamina propria mucosae, we performed ESD to achieve the en bloc resection of the lesion. Outcomes: Conclusive diagnosis of gastric MALT lymphoma was made based on the resected specimen. Lateral and vertical margins were negative. No lymphoma cells were detected using endoscopic biopsy after 5 years. Lessons: Our report suggests that ESD can be considered as alternative treatment for API2-MALT1 positive gastric MALT lymphoma if the lesion was localized within the gastric mucosa.