Rapid Resolution of a Gastric Lymphoma with Helicobacter Eradication Therapy

  • Leah Belle Kosyakovsky University of British Columbia Vancouver-Fraser Medical Program
  • Muhammad Laghari UBC Faculty of Medicine, Division of Gastroenterology
  • Yazeed Alwelaie UBC Department of Laboratory Medicine
  • Kerry Savage UBC Division of Medical Oncology; BC Cancer Agency
  • Eric Yoshida UBC Division of Gastroenterology

Abstract

As one of the most prevalent chronic bacterial infections, Helicobacter pylori  has had a uniquely significant impact on human pathology. Infection with H. pylori has been shown to be involved in a wide array of gastrointestinal diseases, from peptic ulcer disease to gastric malignancy. Here, we present an 82 year-old patient who was found to have a large ulcerated gastric mass, along with a concomitant H. pylori infection.  Gastric biopsies later revealed a gastric MALT (mucosa-associated lymphoid tissue) lymphoma, suspicious of transformation to a high-grade diffuse large B-cell lymphoma. Primary treatment with Helicobacter eradication therapy resulted, remarkably, in complete endoscopic and histologic resolution of the lymphoma only three weeks after the completion of triple therapy. Through this illustrative case, we review the controversies in the management of high-grade gastric lymphoma, as well as the clinical practice surrounding endoscopic surveillance for malignancy follow-up.

Author Biographies

Leah Belle Kosyakovsky, University of British Columbia Vancouver-Fraser Medical Program
UBC M.D. Candidate, Class of 2018
Muhammad Laghari, UBC Faculty of Medicine, Division of Gastroenterology
UBC Gastroenterology Fellow, MBBS, FRCPC
Yazeed Alwelaie, UBC Department of Laboratory Medicine
UBC Pathology Resident
Kerry Savage, UBC Division of Medical Oncology; BC Cancer Agency

MD FRCP(C), Associate Professor of Medicine

Eric Yoshida, UBC Division of Gastroenterology
MD MHSc FRCP(C), Professor of Medicine
Published
2018-03-09
Section
Case and Elective Reports