The Progression of Esophageal Mucosa-associated Lymphoid Tissue Lymphoma after <i>Helicobacter pylori </i>Eradication Therapy: A Case Report and Discussion of Therapeutic Options

Abstract

A 50-year-old woman with epigastric discomfort was referred to our hospital. Esophagogastroduodenoscopy showed flat, elevated, submucosal tumor-like lesions in the esophagus. Extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) of the esophagus was diagnosed based on the examination of an endoscopic biopsy specimen. Computed tomography showed the enlargement of a lymph node in the gastric cardia. The present case showed disease progression despite Helicobacter pylori eradication therapy and achieved partial remission after rituximab monotherapy. The patient remained in partial remission for 20 months. This case suggests that esophageal MALT lymphoma with lymph node involvement does not respond to H. pylori eradication therapy and that it requires systemic treatment.

Primary Esophageal Mucosa-associated Lymphoid Tissue Lymphoma: A Rare Case Report and Review of Other Published Data

“…17,18 In contrast, two other patients treated with H. pylori eradication as the first-line therapy showed partial or no responses; however, these were staged as stage II or IV. 19,20 In our case, the patient's…”

“…Furthermore, H. pylori eradication is advantageous due to its low cost and its being nearly harmless to the patient. However, it appears to be challenging to achieve complete remission in advanced stages of PEML through H. pylori treatment alone, 19,20 suggesting the need for additional treatment alongside H. pylori eradication. The effectiveness of H. pylori eradication in PEML requires further verification.…”