Abstract
Treatment choice in gastric mucosa-associated lymphoid tissue (MALT) lymphoma is dependent on the stage and biological rate of progression and transformation as reflected by grade. In pre-treatment, endoscopic biopsy samples, histological and biological criteria to recognize tumor components with a significantly adverse impact on prognosis have to be defined to select patients who may benefit from Helicobacter pylori (H. pylori) eradication as single modality treatment and those who need “classical” anti-cancer therapy. In a consecutive series of 106 patients with gastric MALT-non-Hodgkin’s lymphoma (NHL), it was possible to define criteria to differentiate between low-grade and highgrade (transformed) disease. Moreover, within the low-grade group, a category with a diffuse large cell component of 1–10 with or without non-confluent clusters of blasts could be separated with a significantly worse prognosis (10-year disease-specific survival 90% versus 75%). No clinical parameters of known prognostic significance could account for this difference. In a separate series of 19 patients treated with H. pylori eradication, this morphology was strongly related to the chance of reaching complete remission as an independent risk factor. This suggests that it is possible to define criteria in endoscopic biopsy samples to recognize clinically relevant tumor-progression and that these criteria may serve as a guideline in the choice of therapy.
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References
Chan JKC, Ng CS, Isaacson PG (1990) Relationship between high-grade and low-grade B-cell mucosa-associated lymhpoid tissue lymphoma of the stomach. Am J Pathol 136:1153–1164
De Jong D, Boot H, van Heerde P, Hart AAM, Taal BG (1997) Histological grading in gastric lymphoma: pre-treatment criteria and clinical relevance. Gastroenterology 112:1466–1474
Greiner A, Knörr C, Qin Y, Sebald W, Schimpl A, Müller-Hermelink H-K (1997) Lowgrade B-cell lymphomas of mucosa-associated lymphoid tissue (MALT-type) require CD40-mediated signalling and TH2-type cytokines for in vitro growth and differentiation. Am J Pathol 150:1583–1593
Hussell T, Isaacson PG, Crabtree JE, Spencer J (1996) Helicobacter pylori-specific tumorinfiltrating T-cells provide contact dependant help for the growth of malignant B-cells in low-grade gastric lymphomas of mucosa-associated lymphoid tissue. J Pathol 178:122–127
Hintze RE (1989) Endoskopische Diagnostik der gastrointestinalen Lymphome. Verdauungskrankheiten 7:18–24
Wotherspoon AC, Doglioni C, Isaacson PG (1992) Low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT): a multifocal disease. Histopathology 20:29–34
Zukerberg LR, Ferry JA, Southern JF, Harris NL (1990) Lymphoid infiltrates of the stomach: evaluation of histologica criteria for the diagnosis of low-grade gastric lymphoma on endoscopic biopsy specimens. Am J Surg Pathol 14:1089–1099
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© 2000 Springer-Verlag Berlin Heidelberg
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de Jong, D., Boot, H., Taal, B. (2000). Histological Grading with Clinical Relevance in Gastric Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma. In: Fischbach, W. (eds) Gastrointestinal Lymphoma. Recent Results in Cancer Research, vol 156. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-57054-4_4
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DOI: https://doi.org/10.1007/978-3-642-57054-4_4
Publisher Name: Springer, Berlin, Heidelberg
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