Radiological features in paediatric primary gastric MALT lymphoma and association with Helicobacter pylori

Abstract

Primary malignant tumours of the stomach are very rare in children, most being lymphomas and sarcomas. The majority of primary gastric lymphomas are high-grade non-Hodgkin's lymphomas and are of B-cell origin. However, a significant number are low-grade B-cell lymphomas that are derived from mucosa-associated lymphoid tissue (MALT) that is not found in the normal stomach. Helicobacter pylori infection predisposes to the development of MALT in the stomach and provides the pathogenic background for MALT-type lymphomagenesis. To our knowledge, only eight paediatric cases of primary gastric lymphoma have been described. The diagnosis and follow-up of gastric lymphoma are mainly made by endoscopy. Nevertheless, radiologists must be aware of this disease because it may be observed on radiological examinations that are performed for non-specific upper digestive symptoms in children.

Unexpected finding of laparoscopic appendectomy: appendix MALT lymphoma in children

“…MALT often develops within the context of a pre-existing inflammatory response due to infection or to autoimmune disorder. Many studies show the relationship between H. pylori infection and gastric MALT lymphoma [11,12]; some authors have reported a regression of MALT lymphoma in parotid gland [13], lip gland [14], small intestine [15] and rectum [16] following H. pylori eradication. Other risk factors for MALT lymphoma include autoimmune diseases like Hashimoto thyroiditis or Sjogren syndrome, and Borrelia burgdorferi for skin lymphoma.…”

Recurrent Neuroblastoma With Gastric Invasion

“…Highgrade MALT lymphomas show proliferation of large transformed lymphocytes with a high mitotic rate in the lamina propria, leading to separation and destruction of the gastric glands. 16 Treatment of gastric lymphoma must take into account a number of factors (MALT vs. non-MALT lymphoma, presence or absence of H. pylori infection, grade of cellular infiltration, macroscopic type) and is outside the scope of this brief report. Leiomyosarcoma is also a rare pediatric tumor, representing about 5% of all gastric sarcomas in a large case series.…”

“…An association between MALT lymphoma and infection with Helicobacter pylori has been shown 18 ; in fact, in certain cases MALT lymphoma can be cured by eradication of the bacterial infection. 16,19 Macroscopically, MALT lymphomas are classified as superficial-spreading, mass-forming, and diffuse-infiltrating types. Microscopically, MALT lymphomas are divided into low-grade and high-grade lesions based on histologic features.…”

“…[10][11][12][13][14][15] Lymphomas are the most common GI primary malignancy in children, occurring primarily in the small bowel and colon and rarely in the stomach. 10,16 Gastric lymphomas are differentiated according to their histology into mucosa-associated lymphoid tissue (MALT) lymphoma and non-MALT lymphoma 17 ; most being non-Hodgkin lymphomas. MALT lymphomas are interesting in that the stomach does not normally contain MALT.…”

Appendiceal MALT Lymphoma in Childhood - Presentation and Evolution

“…MALT often develops within the context of a pre-existing inflammatory response due to infection or to autoimmune disorder. Many studies show the relationship between H. pylori infection and gastric MALT lymphoma (Isaacson & Whright, 1984;Kurugoglu et al, 2002); some authors have reported a regression of MALT lymphoma in parotid gland (Alkan et al, 1996), lip gland (Berrebi et al, 1998), small intestine (Fischbach et al, 1997) Mo et al, 2004). In some patients no risk factors can be identified.…”