RESUMO
We report the regression of coexisting mucosa-associated lymphoid tissue (MALT) lymphomas in the duodenal bulb and gastric corpus brought about by Helicobacter pylori eradication. During an endoscopic examination, multiple polyps in the duodenal bulb were observed in a 62-year-old woman. The pathology of the duodenal polyps was low-grade B-cell MALT lymphoma. Gastric MALT lymphoma was also detected in biopsies of rough mucosa from the gastric corpus. Southern blot analysis showed rearranged bands of DNA immunoglobulin heavy chain J portion (IgH-J) in both lesions, but the positions of these bands were different in the two lesions. H. pylori was recognized in the gastric mucosa by positive serum H. pylori antibody and urease tests, while bacterial bodies were not found in the duodenal bulb. With 1 year after the successful eradication of H. pylori, both the lesions, that in the duodenal bulb and that in the gastric corpus, had disappeared. Furthermore, positive rearrangement of IgH-J was not found at either of the lesion sites. In May 2000, 3 years after the treatment, endoscopic surveillance failed to find any recurrence of these malignant lymphomas.
Assuntos
Neoplasias Duodenais/patologia , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Linfoma de Zona Marginal Tipo Células B/patologia , Neoplasias Gástricas/patologia , Neoplasias Duodenais/complicações , Neoplasias Duodenais/imunologia , Endoscopia Gastrointestinal , Feminino , Infecções por Helicobacter/complicações , Humanos , Cadeias Pesadas de Imunoglobulinas/análise , Cadeias J de Imunoglobulina/análise , Linfoma de Zona Marginal Tipo Células B/complicações , Linfoma de Zona Marginal Tipo Células B/imunologia , Pessoa de Meia-Idade , Gastropatias/complicações , Gastropatias/tratamento farmacológico , Neoplasias Gástricas/complicações , Neoplasias Gástricas/imunologiaRESUMO
Gastric carcinoid tumors associated with chronic atrophic gastritis type A have been reported to show good prognosis, because invasion and metastasis are rare. We report a case of gastric carcinoid tumor associated with hypergastrinemia that showed no malignant changes for 12 years. A 15-year-old man with abdominal discomfort underwent endoscopic examination. A polypoid lesion was detected on the atrophic mucosa of the fundus, and was diagnosed as a carcinoid tumor. Serological examination revealed a high level of anti-parietal-cell antibody, suggesting that the patient had chronic atrophic gastritis type A. The tumor was treated by endoscopic mucosal resection. Follow-up examinations were performed for 12 years, but showed no recurrence. This case confirms that gastric carcinoid tumors associated with chronic atrophic gastritis type A may have a good prognosis.