Skip to main content
PMC home page
British Journal of Cancer logoLink to British Journal of Cancer
. 2001 Nov;85(10):1462–1466. doi: 10.1054/bjoc.2001.2070

Somatostatin-receptor scintigraphy for staging and follow-up of patients with extraintestinal marginal zone B-cell lymphoma of the mucosa associated lymphoid tissue (MALT)-type

M Raderer 1, T Traub 2, M Formanek 3, I Virgolini 7, C Österreicher 4, W Fiebiger 1, M Penz 1, U Jäger 1, J Pont 6, A Chott 5, A Kurtaran 2
PMCID: PMC2363931  PMID: 11720429

Abstract

The majority of lymphomas of the mucosa-associated lymphoid tissue (MALT)-type arise in the stomach, but extragastric locations are also frequently encountered. Due to previous results indicating that somatostatin receptor (SSTR)-expression distinguishes between gastric and extragastric MALT-type lymphoma, we have initiated a study to evaluate the role of SSTR-scintigraphy for staging and follow-up of patients with extragastric manifestations of MALT-type lymphoma. A total of 30 consecutive patients, including 24 with primary extragastric MALT-type lymphoma, 5 patients with dissemination to extragastric sites (including colon, lung, parotid, ocular adnexa and breast) following an initial gastric MALT-lymphoma and one patient with spread to stomach, lung and lymph nodes following parotid lymphoma were prospectively studied. All patients had histologically verified MALT-type lymphoma: 2 patients had lymphoma presenting in the lung, 9 in the ocular adnexa, 7 had lymphomas in the parotid, 2 patients had disease located in the breast, 3 patients had lymph-node relapse following MALT-type lymphoma of the parotid, the lacrimal gland and the thyroid, and 1 had primary MALT-lymphoma of the liver. All patients underwent SSTR-scintigraphy using 111In-DTPA-D-Phe1-Octreotide (111In-OCT) before initiation of therapy, while 13 also had a second scan after treatment. The results of gamma camera imaging were compared to conventional staging. No positive scans could be obtained in patients with dissemination following gastric lymphoma, while all patients with primary extragastric lymphoma had positive scans at the site of histologically documented involvement before initiation of therapy. In addition, also the patient with secondary spread to stomach, lung and lymph nodes was positive in all documented lymphoma sites. In one patient, focal tracer uptake in projection to the maxillary sinus was documented, which was bioptically verified as inflammation. In the scans performed after therapy, focal tracer accumulation in the left orbit indicated persistance of disease following irradiation in one patient with otherwise negative work-up, which was verified by MRI and biopsy 6 months later. In another patient, a positive scan indicated disease relapse in the lacrimal gland 9 months before clinical verification by means of ultrasound. In one patient, a focus not present in the pretherapeutic scan was found in the ethmoidal sinus, corresponding to a hyperplastic polyp. Both SST-scan as well as CT indicated disease persistance in one case, while negative scans corresponding to complete remission as judged by conventional staging were obtained following therapy in the remaining patients, and absence of relapse has been confirmed for a median follow-up of 2 years. These results indicate that 111In-OCT is an excellent tool for staging and non-invasive therapy-monitoring in extragastric MALT-type lymphomas. These data further confirm our initial finding that gastric MALT-type lymphomas do not express relevant amounts of respective SSTR, and that SSTR-scanning is able to distinguish between gastric vs extragastric origin of MALT-type lymphoma irrespective of the site of presentation.© 2001 Cancer Research Campaign  http://www.bjcancer.com

Keywords: somatostatin, extraintestinal MALT-lymphoma, scintigraphy

Full Text

The Full Text of this article is available as a PDF (51.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Goldsmith S. J., Macapinlac H. A., O'Brien J. P. Somatostatin-receptor imaging in lymphoma. Semin Nucl Med. 1995 Jul;25(3):262–271. doi: 10.1016/s0001-2998(95)80015-8. [DOI] [PubMed] [Google Scholar]
  2. 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]
  3. Harris N. L., Jaffe E. S., Stein H., Banks P. M., Chan J. K., Cleary M. L., Delsol G., De Wolf-Peeters C., Falini B., Gatter K. C. A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood. 1994 Sep 1;84(5):1361–1392. [PubMed] [Google Scholar]
  4. Hoffmann M., Kletter K., Diemling M., Becherer A., Pfeffel F., Petkov V., Chott A., Raderer M. Positron emission tomography with fluorine-18-2-fluoro-2-deoxy-D-glucose (F18-FDG) does not visualize extranodal B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT)-type. Ann Oncol. 1999 Oct;10(10):1185–1189. doi: 10.1023/a:1008312726163. [DOI] [PubMed] [Google Scholar]
  5. Isaacson P., Wright D. H. Malignant lymphoma of mucosa-associated lymphoid tissue. A distinctive type of B-cell lymphoma. Cancer. 1983 Oct 15;52(8):1410–1416. doi: 10.1002/1097-0142(19831015)52:8<1410::aid-cncr2820520813>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
  6. Leners N., Jamar F., Fiasse R., Ferrant A., Pauwels S. Indium-111-pentetreotide uptake in endocrine tumors and lymphoma. J Nucl Med. 1996 Jun;37(6):916–922. [PubMed] [Google Scholar]
  7. Pileri S. A., Milani M., Fraternali-Orcioni G., Sabattini E. From the R.E.A.L. Classification to the upcoming WHO scheme: a step toward universal categorization of lymphoma entities? Ann Oncol. 1998 Jun;9(6):607–612. doi: 10.1023/a:1008278706002. [DOI] [PubMed] [Google Scholar]
  8. Raderer M., Valencak J., Pfeffel F., Drach J., Pangerl T., Kurtaran A., Hejna M., Vorbeck F., Chott A., Virgolini I. Somatostatin receptor expression in primary gastric versus nongastric extranodal B-cell lymphoma of mucosa-associated lymphoid tissue type. J Natl Cancer Inst. 1999 Apr 21;91(8):716–718. doi: 10.1093/jnci/91.8.716. [DOI] [PubMed] [Google Scholar]
  9. Raderer M., Vorbeck F., Formanek M., Osterreicher C., Valencak J., Penz M., Kornek G., Hamilton G., Dragosics B., Chott A. Importance of extensive staging in patients with mucosa-associated lymphoid tissue (MALT)-type lymphoma. Br J Cancer. 2000 Aug;83(4):454–457. doi: 10.1054/bjoc.2000.1308. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Thieblemont C., Berger F., Dumontet C., Moullet I., Bouafia F., Felman P., Salles G., Coiffier B. Mucosa-associated lymphoid tissue lymphoma is a disseminated disease in one third of 158 patients analyzed. Blood. 2000 Feb 1;95(3):802–806. [PubMed] [Google Scholar]
  11. Witzig T. E., Letendre L., Gerstner J., Schroeder G., Mailliard J. A., Colon-Otero G., Marschke R. F., Windschitl H. E. Evaluation of a somatostatin analog in the treatment of lymphoproliferative disorders: results of a phase II North Central Cancer Treatment Group trial. J Clin Oncol. 1995 Aug;13(8):2012–2015. doi: 10.1200/JCO.1995.13.8.2012. [DOI] [PubMed] [Google Scholar]
  12. Zucca E., Roggero E., Bertoni F., Cavalli F. Primary extranodal non-Hodgkin's lymphomas. Part 1: Gastrointestinal, cutaneous and genitourinary lymphomas. Ann Oncol. 1997 Aug;8(8):727–737. doi: 10.1023/a:1008282818705. [DOI] [PubMed] [Google Scholar]
  13. van den Anker-Lugtenburg P. J., Löwenberg B., Lamberts S. W., Krenning E. P. The relevance of somatostatin receptor expression in malignant lymphomas. Metabolism. 1996 Aug;45(8 Suppl 1):96–97. doi: 10.1016/s0026-0495(96)90095-5. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES