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Diagnosis and posttreatment follow-up of Helicobacter pylori-positive
gastric lymphoma of mucosa-associated lymphoid tissue: histology,
polymerase chain reaction, or both?
A Savio, G Franzin, AC Wotherspoon, G Zamboni, R Negrini, F Buffoli, TC Diss, L Pan and PG Isaacson
Ospedale S. Orsola FBF, Brescia, Italy.
The differential diagnosis between Helicobacter pylori (H pylori-
associated chronic gastritis and low-grade B-cell gastric lymphoma of
mucosa-associated lymphoid tissue (MALT) and the assessment of endoscopic
biopsy specimens after treatment of lymphoma can be problematic. Although
immunocytochemistry can be used to identify clonal B-cell populations,
which are characteristic of MALT lymphoma, its application to small biopsy
specimens and the subsequent interpretation can be difficult. The
polymerase chain reaction (PCR) can detect clonal B-cell populations by
analysis of the Ig heavy chain gene in routinely fixed paraffin-embedded
material and might provide a useful tool in the assessment of these
specimens. We have investigated the value of histology and PCR in the
diagnosis of lymphoma and its followup in formalin-fixed paraffin-embedded
gastric endoscopy biopsy specimens from 69 sequential patients selected on
the basis of a dense mucosal lymphoid infiltrate associated with H pylori
infection. Histologic evidence of MALT lymphoma was identified in 13 cases,
9 of which showed PCR-detected monoclonality. In 12 of 13 cases, H pylori
was eradicated, and in 11 of 12 cases, histologic regression of the
lymphoma followed. PCR evidence of monoclonality disappeared in 6 of 9
originally monoclonal cases. This was synchronous with histologic remission
in 1 case, but lagged in the remaining 5 cases by up to 28 months. Two of
the 3 of the 9 cases originally monoclonal by PCR that have not shown
molecular regression have monoclonal-amplified products 17 and 24 months
after negative histology. In 3 cases, the histology of the biopsies was
considered indeterminate or discordant. In 1 of these cases, the histologic
features were obscured by crush artefact. In a second case, there was
molecular evidence of monoclonality in the absence of histologic features
suggestive of lymphoma; this persisted after H pylori eradication. An
additional single case originally diagnosed as reactive developed a PCR
detectable clonal population 29 months after original evaluation in the
absence of histologic features of lymphoma but in the presence of
persistent H pylori infection. These findings suggest that the histologic
assessment of gastric biopsies remains the method of choice for the
diagnosis of lymphoma in gastric endoscopic biopsies with a dense mucosal
lymphoid infiltrate. PCR provides a useful technique to support the
diagnosis if clonal amplification products are found. The significance of
PCR detected clonality in the absence of histologic evidence of lymphoma in
uncertain but may represent a stage of tumor progression/regression when
the clonal population is insufficient to be detected by conventional
histology. This is supported by the evidence that PCR- detectable
monoclonality can persist after treatment and the disappearance of
histologically detectable lymphoma.
Volume 87,
Issue 4,
pp. 1255-1260,
02/15/1996
Copyright © 1996 by The American Society of Hematology
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23(31):
8018 - 8024.
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[Full Text]
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|
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16(9):
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[Full Text]
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|
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December 1, 2004;
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1258 - 1263.
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|
|
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|
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4(3):
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[Abstract]
[Full Text]
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|
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|
|
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May 1, 2002;
50(90003):
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[Full Text]
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|
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|
|
|
|
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|
|
|
|
|
|
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April 1, 2001;
19(7):
2041 - 2048.
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[Full Text]
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|
|
|
|
|
|
|
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April 1, 2001;
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|
|
|
|
|
|
|
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[Full Text]
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|
|
|
|
|
|
|
A MORGNER, E BAYERDORFFER, A NEUBAUER, and M STOLTE
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March 1, 2001;
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[PDF]
|
|
|
|
|
|
|
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January 1, 2001;
2001(1):
241 - 258.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M A Hoeve, A D G Krol, K Philippo, P W B Derksen, R A Veenendaal, E Schuuring, P. M Kluin, and J H J M v. Krieken
Limitations of clonality analysis of B cell proliferations using CDR3 polymerase chain reaction
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August 1, 2000;
53(4):
194 - 200.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
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The gastric marginal zone B-cell lymphoma of MALT type
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July 15, 2000;
96(2):
410 - 419.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M.-Q. Du, H. Peng, H. Liu, R. A. Hamoudi, T. C. Diss, T. G. Willis, H. Ye, A. Dogan, A. C. Wotherspoon, M. J. S. Dyer, et al.
BCL10 gene mutation in lymphoma
Blood,
June 15, 2000;
95(12):
3885 - 3890.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Zucca, F. Bertoni, E. Roggero, G. Bosshard, G. Cazzaniga, E. Pedrinis, A. Biondi, and F. Cavalli
Molecular Analysis of the Progression from Helicobacter pylori-Associated Chronic Gastritis to Mucosa-Associated Lymphoid-Tissue Lymphoma of the Stomach
N. Engl. J. Med.,
March 19, 1998;
338(12):
804 - 810.
[Full Text]
[PDF]
|
|
|
|
|
