HELICOBACTER-PYLORI AND GASTRIC MALT LYMPHOMA

Helicobacter pylori gastritis has been implicated as a cause of gastri c and duodenal ulcers as well as of gastric carcinoma. However, chroni c H, pylori gastritis may also play a role in the development of non-H odgkin's gastric lymphoma, In a recent study, patients with this tumor were significantly more likely than matched controls to have evidence of prior H. pylori infection [1]. A specific association has also bee n recognized between H, pylori and the development of low-grade B-cell gastric lymphomas arising in mucosa-associated lymphoid tissue (MALT) , also known as MALT lymphomas [2, 3], To our knowledge, little has be en written about the radiologic manifestations of these H, pylori-asso ciated MALT lymphomas. We recently had the opportunity to perform a se ries of barium studies on a patient with this tumor, We therefore pres ent a case of gastric MALT lymphoma and discuss its significance. tone al lymphadenopathy or other findings of lymphoma. A chest radiograph a nd bone marrow biopsy were normal. The patient was diagnosed as having a low-grade gastric MALT lymphoma (stage IE) and was treated with fou r courses of chemotherapy (Cytoxan [cyclophosphamide; Bristol-Myers Sq uibb, Princeton, NJ] and prednisone) followed by radiation therapy to the upper abdomen. Her upper abdominal pain resolved during treatment. Several follow-up double-contrast upper gastrointestinal examinations during the next 2 years revealed continued nodularity of the stomach with partial regression of the tiny, nodular lesions seen on the origi nal study. However, the patient then developed recurrent abdominal pai n, and a repeat CT scan revealed gastrohepatic, mesenteric, right exte rnal iliac, and bilateral inguinal adenopathy highly suspicious for re current lymphoma.