Regression of primary gastric B-cell mucosa-associated lymphoid tissue (MALT) lymphoma after eradication of Helicobacter pylori.

OBJECTIVE: primary gastric B-cell lymphoma of the mucosa-associated lymphoid tissue type has been linked to infection of the gastric mucosa with Helicobacter pylori. The eradication of this pathogen with antibiotics can lead to regression of this type of lymphoma. The objective of this study was to describe the clinical, endoscopic and histologic evolution in 6 patients with primary gastric B-cell lymphoma of the mucosa-associated lymphoid tissue type treated with eradication of H. pylori. METHOD: descriptive study of a retrospective case series. Patients with low-grade gastric mucosa-associated lymphoid tissue type lymphoma were initially treated with eradication therapy for H. pylori. We evaluated their clinical, endoscopic and histologic course in sequential follow-up visits after initial therapy. RESULTS: six patients who satisfied all selection criteria were studied. In five of six patients H. pylori was eradicated and the lymphoma showed regression within 6 to 24 months. In one patient transition of low-grade to high-grade gastric lymphoma occurred. CONCLUSIONS: these results, along with similar findings from other studies, suggest eradication of H. pylori should be the initial treatment of choice for low-grade B-cell gastric mucosa-associated lymphoid tissue type lymphoma in the early stages. The most appropriate duration of follow-up is unknown, but prolonged follow-up is indicated to detect recurrences.