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Prepublished online as a Blood First Edition Paper on November 27, 2002; DOI 10.1182/blood-2002-10-3167.
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Blood, 1 April 2003, Vol. 101, No. 7, pp. 2547-2550
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Brief report
High incidence of t(11;18)(q21;q21) in Helicobacter
pylori-negative gastric MALT lymphoma
Hongtao Ye,
Hongxiang Liu,
Markus Raderer,
Andreas Chott,
Agnes Ruskone-Fourmestraux,
Andrew Wotherspoon,
Martin J. S. Dyer,
Shih-Sung Chuang,
Ahmet Dogan,
Peter G. Isaacson, and
Ming-Qing Du
From the Department of Histopathology, University
College London, United Kingdom; Department of Internal
Medicine/Clinical Pathology, University of Vienna,
Austria; Service de Gastro-enterologie, Hotel-Dieu,
Assistance Publique Hôpitaux de Paris (AP-HP), Groupe d'Etude
des Lymphomes Dignestifs (GELD), Paris, France; Department
of Histopathology, The Royal Marsden National Health Service (NHS)
Trust, London, United Kingdom; Department of Haematology,
University of Leicester, United Kingdom; Department of
Pathology, Chi-Mei Medical Center, Taiwan.
In approximately 5% to 10% of gastric
mucosa-associated lymphoid tissue (MALT) lymphomas, evidence of
Helicobacter pylori infection is absent, and their
pathogenesis is poorly understood. We reviewed the clinical data and
histology, and we examined t(11;18)(q21;q21) and BCL10 expression
pattern in 17 such cases. In each case, the absence of H
pylori was confirmed by negative serology and
histology/immunohistochemistry. Five cases with stage IE
disease were first treated with antibiotics, and none of them showed
any endoscopic or histologic response. Review of the histology failed
to identify any apparent difference between gastric MALT lymphomas with
and without H pylori infection. Reverse
transcription-polymerase chain reaction (RT-PCR) showed t(11;18)(q21;q21) in 9 (53%) of 17 cases, more frequent in lymphomas at stage IIE or above (5 of 6) than those at stage
IE (3 of 10). Two t(11;18)(q21;q21)-positive lymphomas were
treated by partial gastrectomy and more than 16 years later showed
lymphoma relapse in the gastric stump with dissemination to other
mucosal sites, poorly responsive to therapy. BCL10 nuclear expression
was observed in 7 of 8 t(11;18)(q21;q21)-positive cases and 4 of 7 t(11;18)(q21;q21)-negative cases, including one case suspicious for a
BCL10-involved chromosomal translocation. Our results show that
t(11;18)(q21;q21) occurs at a high frequency in H
pylori-negative gastric MALT lymphomas. Translocation-positive
gastric MALT lymphomas tend to be aggressive, and patients with such
lymphomas might benefit from prompt treatment and close follow-up.
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