The Progression of Esophageal Mucosa-associated Lymphoid Tissue Lymphoma after Helicobacter pylori Eradication Therapy: A Case Report and Discussion of Therapeutic Options

Intern Med. 2019 Jan 15;58(2):207-212. doi: 10.2169/internalmedicine.1112-18. Epub 2018 Aug 24.

Abstract

A 50-year-old woman with epigastric discomfort was referred to our hospital. Esophagogastroduodenoscopy showed flat, elevated, submucosal tumor-like lesions in the esophagus. Extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) of the esophagus was diagnosed based on the examination of an endoscopic biopsy specimen. Computed tomography showed the enlargement of a lymph node in the gastric cardia. The present case showed disease progression despite Helicobacter pylori eradication therapy and achieved partial remission after rituximab monotherapy. The patient remained in partial remission for 20 months. This case suggests that esophageal MALT lymphoma with lymph node involvement does not respond to H. pylori eradication therapy and that it requires systemic treatment.

Keywords: Helicobacter pylori; MALT; eradication therapy; esophagus; rituximab.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Antineoplastic Agents, Immunological / therapeutic use
  • Disease Progression
  • Esophageal Neoplasms / drug therapy
  • Esophageal Neoplasms / microbiology
  • Esophageal Neoplasms / pathology*
  • Female
  • Helicobacter Infections / complications
  • Helicobacter Infections / drug therapy*
  • Helicobacter pylori*
  • Humans
  • Lymphoma, B-Cell, Marginal Zone / drug therapy
  • Lymphoma, B-Cell, Marginal Zone / microbiology
  • Lymphoma, B-Cell, Marginal Zone / pathology*
  • Male
  • Middle Aged
  • Rituximab / therapeutic use
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents
  • Antineoplastic Agents, Immunological
  • Rituximab