Mucosa-associated lymphoid tissue (MALT) lymphoma is the most common type of extra-nodal non-Hodgkin lymphoma, which mostly involves the stomach. The clinical suspicion and diagnosis are often challenging because of the lack of specific symptoms and conventional endoscopic findings. Three magnifying endoscopic signs of the gastric mucosa have been described as highly specific to the diagnosis of MALT lymphoma, such as (i) tree-like appearance of the microvessels; (ii) non-structural area; and (iii) ballooning crypt pattern. We report the case of a middle-aged woman in which these signs appeared chronologically over a period of 2 years, showing the association of the sequence of the endoscopic findings and the final histological diagnosis of gastric MALT lymphoma.
Keywords
Lymphoma, B-Cell, Marginal Zone, Endoscopy
References
ZuccaE, RoggeroE, BertoniF, CavalliF. Primary extranodal non-Hodgkin’s lymphomas. Part 1: Gastrointestinal, cutaneous and genitourinary lymphomas.
NakamuraS, MatsumotoT, IidaM, YaoT, TsuneyoshiM. Primary gastrointestinal lymphoma in Japan: a clinicopathologic analysis of 455 patients with special reference to its time trends.
ZulloA, HassanC, RidolaL, RepiciA, MantaR, AndrianiA. Gastric MALT lymphoma: old and new insights.
Ann Gastroenterol. 2014;27(1):27-33. [PMID:24714739]
NonakaK, OhataK, MatsuhashiN, et al. Is narrow‐band imaging useful for histological evaluation of gastric mucosa‐associated lymphoid tissue lymphoma after treatment?
AnagnostopoulosGK, YaoK, KayeP, et al. High-resolution magnification endoscopy can reliably identify normal gastric mucosa, Helicobacter pylori-associated gastritis, and gastric atrophy.
YamasakiY, UedoN, KanzakiH, et al. Investigation of mucosal pattern of gastric antrum using magnifying narrow-band imaging in patients with chronic atrophic fundic gastritis.
OnoS, KatoM, OnoY, et al. Characteristics of magnified endoscopic images of gastric extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue, including changes after treatment.
NonakaK, IshikawaK, AraiS, et al. A case of gastric mucosa-associated lymphoid tissue lymphoma in which magnified endoscopy with narrow band imaging was useful in the diagnosis.
ZuccaE, Copie-BergmanC, RicardiU, ThieblemontC, RadererM, LadettoM. Gastric marginal zone lymphoma of MALT type: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.