Trisomy 3 may predict a poor response of gastric MALT lymphoma to Helicobacter pylori eradication therapy.

AIM: To investigate the relation of the response to Helicobacter pylori eradication therapy to the depth of tumor invasion and chromosome abnormalities in patients with mucosa-associated lymphoid tissue (MALT) lymphoma and to determine the clinical value of aneuploidy. METHODS: We studied 13 patients with localized gastric MALT lymphoma of stage E1. Before eradication therapy, the depth of tumor invasion was assessed by endoscopic ultrasonography in 8 patients and by endoscopic examination and gastrointestinal series in the remaining patients. To detect chromosomal abnormalities, paraffin-embedded tissue sections of diagnostic biopsy specimens underwent tissue-fluorescence in situ hybridization (FISH), using chromosome-specific alpha-satellite DNA probes for chromosomes 3,7,12, and 18 and YAC clones for t(11;18)(q21;q21). RESULTS: Seven of the 13 patients had complete regression (CR) in response to H pylori eradication therapy. No patient with CR had submucosal tumor invasion. Trisomy 18 was seen in 1 patient with CR, and both trisomies 12 and 18 were present in another patient with CR. All patients with no response or progressive disease had deep submucosal tumor invasion and showed t(11;18)(q21;q21) or trisomy 3. Trisomy 7 was not detected in this series of patients. CONCLUSION: The depth of tumor invasion is an accurate predictor of the response of stage E1 MALT lymphoma to H pylori eradication therapy and is closely associated with the presence of chromosomal abnormalities. Trisomy 3 may predict the aggressive development of MALT lymphoma.

[A hairy B cell lymphoproliferative disorder resembling hairy cell leukemia].

This case report describes a hairy B cell lymphoproliferative disorder (HBLD) with clinical and hematological features resembling hairy cell leukemia. The patient was a 29-year-old female who demonstrated atypical lymphocytes in her peripheral blood. Physical examination demonstrated splenomegaly, but there were no palpable superficial lymph nodes. Hematological examination showed a leukocyte count of 10.6 x 10(3)/mm3 with 41% atypical lymphocytes. Bone marrow examination showed a normal cellular and an atypical lymphocyte count of 42%. The atypical lymphocytes had microvilli and prominent membranous ruffles on their surfaces. Atypical lymphocytes expressed CD5- CD10- CD11c+ CD19+ CD20+ CD23- CD25- on the surface of the cells on examination by with a fluorescence activated cell sorter. Although these findings were similar to hairy cell leukemia, Japanese variant, the surface marker of the kappa chain and lambda chain was unbiased and studies of immunoglobulin gene rearrangements and expression showed polyclonal proliferation of B cells. Therefore, we diagnosed this patient as having HBLD. Because she did not demonstrate anemia or thrombocytopenia, she is not currently receiving medication. To date, the atypical lymphocyte count has not changed.

[Successful treatment of long-standing iron-deficiency anemia in adults by eradication of Helicobacter pylori].

We report two cases of long-standing iron-deficiency anemia in a young man and an elderly woman that improved after eradication of Helicobacter pylori. Neither patient demonstrated any bleeding symptoms nor reported an extremely unbalanced diet. However, H. pylori infection was demonstrated with the urea breath test. After successful eradication of H. pylori, the iron-deficiency anemia dramatically improved in both patients, making it unnecessary to administer ferric medicine for about 20 months. These cases suggest that eradication of H. pylori may be useful in treating some patients with long-standing iron-deficiency anemia.

Detection of t(14;18) in follicular lymphoma by dual-color fluorescence in situ hybridization on paraffin-embedded tissue sections.

We studied the incidence of t(14;18)(q32;q21) in 54 patients with follicular lymphoma (FL) by dual-color fluorescence in situ hybridization on paraffin-embedded tissue sections (tissue-FISH) using probes for BCL2 and immunoglobulin heavy chain (IGH) genes. The t(14;18) was detected in 28 (56%) of 50 patients, who were successfully analyzed. On the other hand, BCL2 protein expression was detected in 45 (83%) of 54 patients evaluated by immunohistochemical staining. There was a discrepancy between t(14;18) and BCL2 expression. The absence of t(14;18) was associated with disease-free survival (P=0.02). There was no statistical difference, however, in overall survival and failure-free survival between the t(14;18)-positive and -negative groups. Tissue-FISH should be of great value to detect t(14;18) in FL because this method enabled us to demonstrate specifically t(14;18)-positive individual cells in neoplastic follicles on paraffin-embedded tissue sections. Furthermore, tissue-FISH can be applied to small specimens obtained from endoscopic biopsy or specimens obtained more than 10 years ago. We validated the usefulness of tissue-FISH as a diagnostic procedure and retrospective meta-analysis for malignant lymphoma.

MALT lymphoma at the base of the tongue developing without any background of immunodeficiency or autoimmune disease.

We report a very rare case of a mucosa-associated lymphoid tissue (MALT) lymphoma of the base of the tongue. A 61-year-old woman was admitted to our hospital for further examination of a 12 mm x 15 mm x 5 mm tongue tumor. Histological examination of the tumor revealed a marked lymphoepithelial lesion. Lymphoma cells expressed CD5(-), CD10(-), CD19(+), CD20(+) on the surface of the cells by fluorescence activated cell sorter, and the genotypic analysis of the tumor cells revealed the presence of immunoglobulin heavy chain rearrangement and the absence of BCL-2 gene rearrangement by southern blot hybridization. Furthermore, neither the t(11;18) (q21;q21) translocation nor trisomy 3 was detected in lymphoma cells by fluorescence in situ hybridization method. The tongue tumor was completely resected and no recurrence has been noted in the 13 months to date.