Primary Mucosa-associated Lymphoid Tissue Lymphoma Metachronously Involving Esophagus and Stomach

Abstract

Mucosa-associated lymphoid tissue (MALT) lymphoma is found in various organs as extranodal B cell lymphoma. The gastro-intestinal tract is the most commonly involved extranodal site in MALT lymphoma. However, primary esophageal MALT lymphoma is very rare. In addition, few cases with metachronous gastric involvement have been reported. A 55-year-old man was diagnosed with MALT lymphoma by surveillance esop hagogastroduodenoscopy. A 5 cm esophageal submucosal tumor-like lesion was incidentally revealed by screening esophagogastroduodenoscopy two years prior. Esophagogastroduodenoscopy showed a cylin-drically elongated submucosal mass with normal overlying mucosa in the mid esophagus. He underwent surgery to confirm the diagnosis. The pathologic diagnosis was esophageal MALT lymp homa. He was treated with radiation, which achieved complete remission. Esophagogastroduodenoscopy and chest computed tomography were performed every three to six months, with no evidence of recurrence for 18 months. After 21 months, severa l elevated gastric erosions were found on the great curvature and posterior sides of the midbody and confirmed as MALT lymphoma pathologically. Here we report a case with MALT lymphoma metachronously involving the esophagus and stomach.

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

“…Primary esophageal lymphoma is a rare tumor, and there only 25 case studies of MALT lymphoma in the esophagus have been reported to date (4, 5, 6-28). In the previously reported cases, esophageal MALT lymphoma was treated with surgical resection (7-12), rituximab and/or chemotherapy (12-19, 27, 28), radiotherapy (8, 12, 20-22, 28), endoscopic resection (20-26), and Hp eradication therapy (4, 5, 7, 8, 12, 13, 27); however, a standard treatment remains to be established.…”

Primary Localized Esophageal Mucosa-associated Lymphoid Tissue Lymphoma Treated by Endoscopic Submucosal Dissection

“…Ten of the 22 reported cases with esophageal MALT lymphoma were diagnosed using a conventional biopsy during esophagogastroduodenoscopy as well. Five cases were diagnosed after surgical resection of the esophageal tumor ( 8 , 9 , 19 , 23 , 25 ). Other procedures include endoscopic mucosal resection (n=3) ( 7 , 14 , 15 ), endoscopic ultrasound-guided fine needle aspiration (n=2) ( 13 , 16 ), a stacked forceps biopsy (n=1) ( 22 ), and endoscopic submucosal dissection (n=1) ( 21 ).…”

“…Generally, rituximab-containing chemotherapy regimens are administered for advanced-stage MALT lymphoma. Of note, in one patient, recurrence was detected in the stomach and lung 21 months after resection of localized esophageal MALT lymphoma ( 23 ). Therefore, gastroenterologists should be alert for the emergence of lymphoma involvement in the lung and stomach when monitoring disease relapse or progression in patients with esophageal MALT lymphoma.…”