Helicobacter pylori–Negative MALT Lymphoma Presenting as a Massive Recurrent Gastrointestinal Hemorrhage

Abstract

Primary gastric lymphoma is rare, representing 5% of all primary gastric neoplasms. The presenting complaints of gastric mucosa-associated lymphoid tissue (MALT) lymphoma are usually nonspecific. However, life-threatening gastrointestinal bleeding from the stomach is unusual and sparsely reported. While studies reveal an indolent course, we present a case that presented with massive and recurrent hematemesis leading to hypovolemic shock secondary to endoscopically confirmed MALT lymphoma, which was treated with radiotherapy to achieve remission. She had no autoimmune diseases and tested negative for Helicobacter pylori. Our case emphasizes the importance of early diagnosis and timely intensive radiotherapy of a localized but aggressive gastric MALT lymphoma.

Helicobacter Pylori-Negative MALT Lymphoma: A Series of Two Cases Presenting with Life-Threatening Upper Gastrointestinal Bleeding

“…Hematemesis and hemodynamic instability are rare. Harne et al [6] is the only other case report of H. pylori-negative MALT lymphoma that presented similarly to our two patients with upper gastrointestinal bleeding and hypovolemic shock. Teir case had revealed erythematous, friable mucosa on EGD, whereas our cases uniquely showed bleeding ulcers (Case 1) and an abnormal polypoid lesion (Case 2).…”

Mucosa-Associated Lymphoid Tissue Lymphoma Masked as Gastric Varices With Acute Upper Gastrointestinal Bleeding: A Case Report

“…Only 15.6% of cases have been reported with upper GI bleeding [7]. Life-threatening acute bleeds are rare and seldom described in a few case reports [5,8,9].…”

“…Almost 90% is related to Helicobacter pylori infection [4]. Diagnosis is challenging due to vague clinical presentations and diverse endoscopic appearances [5]. Anemia from chronic or occult gastrointestinal (GI) bleeding is occasionally observed, though acute bleeding is uncommon.…”