Abstract
A 56-year-old female was diagnosed as gastric mucosa associated lymphoid tissue (MALT) lymphoma (Maltoma) 3 years ago. She was treated with oral antibiotics to eradicate Helicobacter pylori (HP) infection, however it was unsuccessful, and the patient was followed. Two years later, right palpebral tumor, which was diagnosed also as MALT lymphoma by biopsy, growth of gastric Maltoma and pulmonary infiltrate were observed. Biospy of gastric Maltoma revealed diffuse infiltration of lymphocytes, which were centrocyte-like, and differentiation to plasma cells in a part was also observed. Laboratory examination revealed monoclonal increase of IgM, λ in the serum, and increase of plasma cell in the bone marrow. The second eradication of HP was successful. The patient was treated with 4 courses of combination therapy with rituximab and 2-chlorodeoxysdenosine (R-2CdA), and palpebral and gastic Maltomas regressed, pulmonary infiltration disappeared, and IgM decreased, however, the latter was not enough. The patient was treated with additional 2 courses of CHOP, and IgM further decreased. Considering the complexity of pathophysiology of MALT lymphoma, careful observation of the patient and the selection of the appropriate therapy are necessary.
