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. 1999 Apr;52(4):313–316. doi: 10.1136/jcp.52.4.313

Coexistent gastric MALT lymphoma and Kaposi sarcoma in an HIV positive patient.

R Chetty 1, S V Pillay 1
PMCID: PMC501342  PMID: 10474529

Abstract

A 47 year old HIV positive male presented with haematemesis and epigastric pain. A gastrectomy was performed for intractable bleeding. The cause of the haematemesis proved to be a Kaposi sarcoma of the stomach which had resulted in mucosal ulceration. Several other smaller foci of Kaposi sarcoma were also present. Coexistent with the Kaposi sarcoma was a dense lymphoid infiltrate with lymphoid follicles and reactive germinal centres. Centrocyte-like cells caused marked effacement and destruction of gastric glands with the formation of lymphoepithelial lesions, typical of a MALT lymphoma. These cells were of B cell lineage and some expressed the HIV antigen, p24. Follicular dendritic cells and macrophages within germinal centres were also p24 positive. Immunohistochemistry and in situ hybridisation did not detect Epstein-Barr virus. Although Helicobacter pylori was not identified by light microscopy in the sections sampled, this does not preclude its possible role, with other cofactors such as HIV, in the causation of the MALT lymphoma.

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Selected References

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  1. Battan R., Raviglione M. C., Palagiano A., Boyle J. F., Sabatini M. T., Sayad K., Ottaviano L. J. Helicobacter pylori infection in patients with acquired immune deficiency syndrome. Am J Gastroenterol. 1990 Dec;85(12):1576–1579. [PubMed] [Google Scholar]
  2. Coker R. J., Lau R., Isaacson P. G., Kelly S. A., Price P., Weber J. Mucosa-associated gastric lymphoma occurring in an HIV-antibody-positive patient. AIDS. 1992 Mar;6(3):336–337. [PubMed] [Google Scholar]
  3. Danzig J. B., Brandt L. J., Reinus J. F., Klein R. S. Gastrointestinal malignancy in patients with AIDS. Am J Gastroenterol. 1991 Jun;86(6):715–718. [PubMed] [Google Scholar]
  4. Dictor M., Rambech E., Way D., Witte M., Bendsöe N. Human herpesvirus 8 (Kaposi's sarcoma-associated herpesvirus) DNA in Kaposi's sarcoma lesions, AIDS Kaposi's sarcoma cell lines, endothelial Kaposi's sarcoma simulators, and the skin of immunosuppressed patients. Am J Pathol. 1996 Jun;148(6):2009–2016. [PMC free article] [PubMed] [Google Scholar]
  5. Edwards P. D., Carrick J., Turner J., Lee A., Mitchell H., Cooper D. A. Helicobacter pylori-associated gastritis is rare in AIDS: antibiotic effect or a consequence of immunodeficiency? Am J Gastroenterol. 1991 Dec;86(12):1761–1764. [PubMed] [Google Scholar]
  6. Eidt S., Schrappe M., Fischer R. Analysis of antral biopsy specimens for evidence of acquired mucosa-associated lymphoid tissue in HIV1-seropositive and HIV1-negative patients. Scand J Gastroenterol. 1995 Jul;30(7):635–639. doi: 10.3109/00365529509096305. [DOI] [PubMed] [Google Scholar]
  7. Friedman S. L., Wright T. L., Altman D. F. Gastrointestinal Kaposi's sarcoma in patients with acquired immunodeficiency syndrome. Endoscopic and autopsy findings. Gastroenterology. 1985 Jul;89(1):102–108. doi: 10.1016/0016-5085(85)90750-4. [DOI] [PubMed] [Google Scholar]
  8. Hussell T., Isaacson P. G., Crabtree J. E., Spencer J. Helicobacter pylori-specific tumour-infiltrating T cells provide contact dependent help for the growth of malignant B cells in low-grade gastric lymphoma of mucosa-associated lymphoid tissue. J Pathol. 1996 Feb;178(2):122–127. doi: 10.1002/(SICI)1096-9896(199602)178:2<122::AID-PATH486>3.0.CO;2-D. [DOI] [PubMed] [Google Scholar]
  9. Isaacson P. G. Gastrointestinal lymphoma. Hum Pathol. 1994 Oct;25(10):1020–1029. doi: 10.1016/0046-8177(94)90060-4. [DOI] [PubMed] [Google Scholar]
  10. Joshi V. V., Gagnon G. A., Chadwick E. G., Berard C. W., McClain K. L., Leach C. T., Jenson H. B., Murphy S. B. The spectrum of mucosa-associated lymphoid tissue lesions in pediatric patients infected with HIV: A clinicopathologic study of six cases. Am J Clin Pathol. 1997 May;107(5):592–600. doi: 10.1093/ajcp/107.5.592. [DOI] [PubMed] [Google Scholar]
  11. Longo D. L., Steis R. G., Lane H. C., Lotze M. T., Rosenberg S. A., Preble O., Masur H., Rook A. H., Fauci A. S., Jacob J. Malignancies in the AIDS patient: natural history, treatment strategies, and preliminary results. Ann N Y Acad Sci. 1984;437:421–430. doi: 10.1111/j.1749-6632.1984.tb37163.x. [DOI] [PubMed] [Google Scholar]
  12. McGrath M. S., Shiramizu B. T., Herndier B. G. Identification of a clonal form of HIV in early Kaposi's sarcoma: evidence for a novel model of oncogenesis, "sequential neoplasia". J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Apr 1;8(4):379–385. [PubMed] [Google Scholar]
  13. Ott G., Kirchner T., Seidl S., Müller-Hermelink H. K. Primary gastric lymphoma is rarely associated with Epstein-Barr virus. Virchows Arch B Cell Pathol Incl Mol Pathol. 1993;64(5):287–291. doi: 10.1007/BF02915124. [DOI] [PubMed] [Google Scholar]
  14. Rivas C., Prieto E., Sánchez-Fayos P., Castrillo J. M. Linfomas gastrointestinales tipo MALT en pacientes con infección por VIH. Med Clin (Barc) 1993 Apr 24;100(16):636–636. [PubMed] [Google Scholar]
  15. Rodríguez-Sanjuán J. C., Naranjo A., Echevarría S., Alvarez-Cañas C. Primary gastric lymphoma in an HIV-infected patient. J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Dec 15;13(5):467–468. doi: 10.1097/00042560-199612150-00014. [DOI] [PubMed] [Google Scholar]
  16. Rotterdam H., Tsang P. Gastrointestinal disease in the immunocompromised patient. Hum Pathol. 1994 Nov;25(11):1123–1140. doi: 10.1016/0046-8177(94)90029-9. [DOI] [PubMed] [Google Scholar]
  17. Teruya-Feldstein J., Temeck B. K., Sloas M. M., Kingma D. W., Raffeld M., Pass H. I., Mueller B., Jaffe E. S. Pulmonary malignant lymphoma of mucosa-associated lymphoid tissue (MALT) arising in a pediatric HIV-positive patient. Am J Surg Pathol. 1995 Mar;19(3):357–363. doi: 10.1097/00000478-199503000-00014. [DOI] [PubMed] [Google Scholar]
  18. Wotherspoon A. C., Diss T. C., Pan L., Singh N., Whelan J., Isaacson P. G. Low grade gastric B-cell lymphoma of mucosa associated lymphoid tissue in immunocompromised patients. Histopathology. 1996 Feb;28(2):129–134. doi: 10.1046/j.1365-2559.1996.292338.x. [DOI] [PubMed] [Google Scholar]
  19. 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]
  20. Wright D. H. Lymphomas of mucosa-associated lymphoid tissue and antigen drive. J Pathol. 1996 Feb;178(2):111–112. doi: 10.1002/(SICI)1096-9896(199602)178:2<111::AID-PATH490>3.0.CO;2-Y. [DOI] [PubMed] [Google Scholar]

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