A case of gastric low grade MALT lymphoma regressed by second line of H. pylori eradication theraphy

Abstract

A 65-year old women visited our hospital for further examination of gastric ulcer lesion. Upper gastrointestinal endoscopy revealed multiple irregular ulcer lesions in the lesser curvature of anglus. Histological examination of biopsy specimens demonstrated diffuse infiltration centrocyte-like cells and formed lymphoepithelial lesions. Helicobacter pylori (H. pylori) was demonstrated by rapid urease test, culture and histological examination. Low grade mucosa-assiciated lymphoid tissue (MALT) lymphoma (stageI) with H. pylori was diagnosis by further examination of endoscopic ultrasonography, Computer tomography and ⁶⁷Ga scintigraphy. One week eradication therapy (lansoprazole 60mg/day + Amoxicillin (AMPC) 1,500mg/day + clarithromycin (CAM) 800mg/day) unsuccessfully carried out and MALT lymphoma cells were remained. H. pylori strain separated from gastric mucosa after the first line eradication was reveled CAM-resistant strain by susceptibility test. Second line eradication (rabeprazole 20mg/day + AMPC 1,500mg/day + metronidazole 750mg/day 1wk) was carried out successfully and the lesion was regressed endoscopically and histologically.