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. 1996 Jun;38(6):837–840. doi: 10.1136/gut.38.6.837

B-cell clonality and infection with Helicobacter pylori: implications for development of gastric lymphoma.

D Sorrentino 1, G F Ferraccioli 1, S DeVita 1, C Avellini 1, C A Beltrami 1, A Labombarda 1, V Bernardis 1, F De Biase 1, A Trevisi 1, B Pivetta 1, M Boiocchi 1, E Bartoli 1
PMCID: PMC1383189  PMID: 8984020

Abstract

BACKGROUND: Although Helicobacter pylori has been implicated in the pathogenesis of gastric mucosa associated lymphoid tissue (MALT) and MALT lymphoma, it is not known how it may trigger these lesions and whether there is an identifiable pre-neoplastic stage. AIMS: To investigate the relation between MALT, H pylori infection, and B-cell clonality (a potential marker of pre-neoplastic lesions). PATIENTS: 141 subjects with simple dyspepsia. METHODS: Gastric biopsy specimens from all patients were examined for MALT and H pylori. Of these, 25 consecutive MALT positive specimens were scored for features of MALT lymphoma and VDJ clonality studied by polymerase chain reaction. RESULTS: Overall, prevalence was 62% for H pylori and 46% for MALT. VDJ clonality was frequent in the sub-group studied (nine of 25), mostly associated with lymphoid follicles (eight of nine or 89%), and with a high scoring for MALT lymphoma. VDJ clonality was equally frequent in patients with and without H pylori (seven of 20 and two of five or 35% and 40% respectively). CONCLUSIONS: B-cell clonality is unexpectedly common in subjects with simple dyspepsia and MALT raising clinical management questions. These findings also suggest that the cascade MALT formation--B-cell clonality--MALT lymphoma may not be uniquely associated with H pylori infection.

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Selected References

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  1. Bayerdörffer E., Neubauer A., Rudolph B., Thiede C., Lehn N., Eidt S., Stolte M. Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure of Helicobacter pylori infection. MALT Lymphoma Study Group. Lancet. 1995 Jun 24;345(8965):1591–1594. doi: 10.1016/s0140-6736(95)90113-2. [DOI] [PubMed] [Google Scholar]
  2. De Vita S., Ferraccioli G., De Re V., Dolcetti R., Carbone A., Bartoli E., Boiocchi M. The polymerase chain reaction detects B cell clonalities in patients with Sjögren's syndrome and suspected malignant lymphoma. J Rheumatol. 1994 Aug;21(8):1497–1501. [PubMed] [Google Scholar]
  3. Diss T. C., Peng H., Wotherspoon A. C., Pan L., Speight P. M., Isaacson P. G. Brief report: a single neoplastic clone in sequential biopsy specimens from a patient with primary gastric-mucosa-associated lymphoid-tissue lymphoma and Sjögren's syndrome. N Engl J Med. 1993 Jul 15;329(3):172–175. doi: 10.1056/NEJM199307153290305. [DOI] [PubMed] [Google Scholar]
  4. Doglioni C., Wotherspoon A. C., Moschini A., de Boni M., Isaacson P. G. High incidence of primary gastric lymphoma in northeastern Italy. Lancet. 1992 Apr 4;339(8797):834–835. doi: 10.1016/0140-6736(92)90280-g. [DOI] [PubMed] [Google Scholar]
  5. Eidt S., Stolte M., Fischer R. Helicobacter pylori gastritis and primary gastric non-Hodgkin's lymphomas. J Clin Pathol. 1994 May;47(5):436–439. doi: 10.1136/jcp.47.5.436. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Galton D. A., Catovsky D., Wiltshaw E. Clinical spectrum of lymphoproliferative diseases. Cancer. 1978 Aug;42(2 Suppl):901–910. doi: 10.1002/1097-0142(197808)42:2+<901::aid-cncr2820420712>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  7. Genta R. M., Hamner H. W., Graham D. Y. Gastric lymphoid follicles in Helicobacter pylori infection: frequency, distribution, and response to triple therapy. Hum Pathol. 1993 Jun;24(6):577–583. doi: 10.1016/0046-8177(93)90235-9. [DOI] [PubMed] [Google Scholar]
  8. Greiner A., Marx A., Heesemann J., Leebmann J., Schmausser B., Müller-Hermelink H. K. Idiotype identity in a MALT-type lymphoma and B cells in Helicobacter pylori associated chronic gastritis. Lab Invest. 1994 Apr;70(4):572–578. [PubMed] [Google Scholar]
  9. Hussell T., Isaacson P. G., Crabtree J. E., Spencer J. The response of cells from low-grade B-cell gastric lymphomas of mucosa-associated lymphoid tissue to Helicobacter pylori. Lancet. 1993 Sep 4;342(8871):571–574. doi: 10.1016/0140-6736(93)91408-e. [DOI] [PubMed] [Google Scholar]
  10. Isaacson P. G. Gastric lymphoma and Helicobacter pylori. N Engl J Med. 1994 May 5;330(18):1310–1311. doi: 10.1056/NEJM199405053301812. [DOI] [PubMed] [Google Scholar]
  11. Isaacson P. G. Lymphomas of mucosa-associated lymphoid tissue (MALT). Histopathology. 1990 Jun;16(6):617–619. doi: 10.1111/j.1365-2559.1990.tb01173.x. [DOI] [PubMed] [Google Scholar]
  12. Isaacson P. G., Spencer J. Is gastric lymphoma an infectious disease? Hum Pathol. 1993 Jun;24(6):569–570. doi: 10.1016/0046-8177(93)90233-7. [DOI] [PubMed] [Google Scholar]
  13. Isaacson P. G., Spencer J. Malignant lymphoma and autoimmune disease. Histopathology. 1993 May;22(5):509–510. doi: 10.1111/j.1365-2559.1993.tb00169.x. [DOI] [PubMed] [Google Scholar]
  14. Parsonnet J., Hansen S., Rodriguez L., Gelb A. B., Warnke R. A., Jellum E., Orentreich N., Vogelman J. H., Friedman G. D. Helicobacter pylori infection and gastric lymphoma. N Engl J Med. 1994 May 5;330(18):1267–1271. doi: 10.1056/NEJM199405053301803. [DOI] [PubMed] [Google Scholar]
  15. Price A. B. The Sydney System: histological division. J Gastroenterol Hepatol. 1991 May-Jun;6(3):209–222. doi: 10.1111/j.1440-1746.1991.tb01468.x. [DOI] [PubMed] [Google Scholar]
  16. Sanchez L., Algara P., Villuendas R., Martinez P., Orradre J. L., Morente M., Piris M. A. B-cell clonal detection in gastric low-grade lymphomas and regional lymph nodes: an immunohistologic and molecular study. Am J Gastroenterol. 1993 Mar;88(3):413–419. [PubMed] [Google Scholar]
  17. Savio A., Franzin G., Wotherspoon A. C., Zamboni G., Negrini R., Buffoli F., Diss T. C., Pan L., Isaacson P. G. Diagnosis and posttreatment follow-up of Helicobacter pylori-positive gastric lymphoma of mucosa-associated lymphoid tissue: histology, polymerase chain reaction, or both? Blood. 1996 Feb 15;87(4):1255–1260. [PubMed] [Google Scholar]
  18. Sigal S. H., Saul S. H., Auerbach H. E., Raffensperger E., Kant J. A., Brooks J. J. Gastric small lymphocytic proliferation with immunoglobulin gene rearrangement in pseudolymphoma versus lymphoma. Gastroenterology. 1989 Jul;97(1):195–201. doi: 10.1016/0016-5085(89)91435-2. [DOI] [PubMed] [Google Scholar]
  19. Stolte M., Eidt S. Healing gastric MALT lymphomas by eradicating H pylori? Lancet. 1993 Sep 4;342(8871):568–568. doi: 10.1016/0140-6736(93)91404-a. [DOI] [PubMed] [Google Scholar]
  20. Thomas G. A., Williams D. Gastric lymphomas. Lancet. 1993 Nov 6;342(8880):1182–1183. doi: 10.1016/0140-6736(93)92168-s. [DOI] [PubMed] [Google Scholar]
  21. Whitehead R., Truelove S. C., Gear M. W. The histological diagnosis of chronic gastritis in fibreoptic gastroscope biopsy specimens. J Clin Pathol. 1972 Jan;25(1):1–11. doi: 10.1136/jcp.25.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Wotherspoon A. C., Doglioni C., Diss T. C., Pan L., Moschini A., de Boni M., Isaacson P. G. Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradication of Helicobacter pylori. Lancet. 1993 Sep 4;342(8871):575–577. doi: 10.1016/0140-6736(93)91409-f. [DOI] [PubMed] [Google Scholar]
  23. Wotherspoon A. C., Ortiz-Hidalgo C., Falzon M. R., Isaacson P. G. Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma. Lancet. 1991 Nov 9;338(8776):1175–1176. doi: 10.1016/0140-6736(91)92035-z. [DOI] [PubMed] [Google Scholar]
  24. al-Saleem T. Gastric lymphomas. Lancet. 1993 Nov 6;342(8880):1183–1184. [PubMed] [Google Scholar]

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