Primary extranodal lymphomas of stomach: Clinical presentation, diagnostic pitfalls and management

Annals of Oncology

Volumn 19, Issue 12, 2008, Pages 1992-1999

  Psyrri, A ^a,b   Papageorgiou, Sotiris ^a   Economopoulos, T ^a  

^a UNIVERSITY OF ATHENS MEDICAL SCHOOL   (Greece)

^b YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Diffuse large B cell lymphomas; Extranodal lymphomas; Helicobacter pylori infection; Mucosa associated lymphoid tissue; Primary gastric lymphomas

Indexed keywords

ADENOSINE DERIVATIVE; ALKYLATING AGENT; ANTHRACYCLINE DERIVATIVE; ANTIBIOTIC AGENT; BETA 2 MICROGLOBULIN; CHLORAMBUCIL; CHLORODEOXYADENOSINE; CLADRIBINE; COMMON ACUTE LYMPHOBLASTIC LEUKEMIA ANTIGEN; CYCLOPHOSPHAMIDE; DOXORUBICIN; EPIRUBICIN; LACTATE DEHYDROGENASE; MITOXANTRONE; NUCLEOSIDE ANALOG; PREDNISONE; PROTEIN BCL 6; RITUXIMAB; UNCLASSIFIED DRUG; VINCRISTINE;

ABDOMINAL PAIN; ADVANCED CANCER; ANOREXIA; AUTOLOGOUS STEM CELL TRANSPLANTATION; B CELL LYMPHOMA; CANCER REGRESSION; CANCER RELAPSE; CANCER STAGING; CANCER SURVIVAL; CARCINOGENESIS; CARDIOTOXICITY; CLINICAL FEATURE; CLINICAL TRIAL; COMBINATION CHEMOTHERAPY; COMPUTER ASSISTED TOMOGRAPHY; CONSERVATIVE TREATMENT; DIFFERENTIAL DIAGNOSIS; DISEASE ASSOCIATION; DRUG EFFICACY; DRUG SAFETY; DRUG TOLERABILITY; DYSPEPSIA; FLUORESCENCE IN SITU HYBRIDIZATION; GASTRECTOMY; GASTROSCOPY; HELICOBACTER INFECTION; HERPES ZOSTER; HUMAN; IMMUNOHISTOCHEMISTRY; INTERMETHOD COMPARISON; INTESTINE LYMPHOMA; LARGE CELL LYMPHOMA; LEUKOPENIA; MONOTHERAPY; MUCOSA ASSOCIATED LYMPHOID TISSUE LYMPHOMA; MULTIPLE CYCLE TREATMENT; NAUSEA; NONHODGKIN LYMPHOMA; POSITRON EMISSION TOMOGRAPHY; PRIORITY JOURNAL; RADIATION DOSE; REVIEW; STANDARDIZATION; VOMITING; WEIGHT REDUCTION;

HELICOBACTER INFECTIONS; HELICOBACTER PYLORI; HUMANS; LYMPHOMA; NEOPLASM STAGING; STOMACH NEOPLASMS;

EID: 56749182288     PISSN: 09237534     EISSN: 15698041     Source Type: Journal    
DOI: 10.1093/annonc/mdn525     Document Type: Review

References (79)

1. Zucca E, Roggero E, Bertoni F, Cavalli F. Primary extranodal non-Hodgkin's lymphomas. Part 1: Gastrointestinal, cutaneous and genitourinary lymphomas. Ann Oncol 1997; 8: 727-737.
2. Economopoulos T, Papageorgiou S, Dimopoulos MA et al. Non-Hodgkin's lymphomas in Greece according to the WHO classification of lymphoid neoplasms. A retrospective analysis of 810 cases. Acta Haematol 2005; 113: 97-103.
3. d'Amore F, Brincker H, Gronbaek K et al. Non-Hodgkin's lymphoma of the gastrointestinal tract: A population-based analysis of incidence, geographic distribution, clinicopathologic presentation features, and prognosis. Danish Lymphoma Study Group. J Clin Oncol 1994; 12: 1673-1684.
4. Koch P, del Valle F, Berdel WE et al. Primary gastrointestinal non-Hodgkin's lymphoma: I. Anatomic and histologic distribution, clinical features, and survival data of 371 patients registered in the German Multicenter Study GIT NHL 01/92. J Clin Oncol 2001; 19: 3861-3873.
5. Papaxoinis G, Papageorgiou S, Rontogianni D et al. Primary gastrointestinal non-Hodgkin's lymphoma: A clinicopathologic study of 128 cases in Greece. A Hellenic Cooperative Oncology Group study (HeCOG). Leuk Lymphoma 2006; 47: 2140-2146.
6. Nakamura S, Yao T, Aoyagi K et al. Helicobacter pylori and primary gastric lymphoma. A histopathologic and immunohistochemical analysis of 237 patients. Cancer 1997; 79: 3-11.
7. Hussell T, Isaacson PG, Crabtree JE, Spencer J. The response of cells from low-grade B-cell gastric lymphomas of mucosa-associated lymphoid tissue to Helicobacter pylori. Lancet 1993; 342: 571-574.
8. Chen LT, Lin JT, Tal JJ et al. Long-term results of anti-Helicobacter pylori therapy in early stage gastric high-grade transformed MALT lymphoma. J Natl Cancer Inst 2005; 97: 1345-1353.
9. Andriani A, Zullo A, Di Raimondo F et al. Clinical and endoscopic presentation of primary gastric lymphoma: A multicentre study. Aliment Pharmacol Ther 2006; 23: 721-726.
10. Wotherspoon A, Doglioni C, Isaacson PG. Low-grade gastric B-cell lymphoma of mucosa-associated lymphoid tissue (MALT): A multifocal disease. Histopathology 1992; 20: 29-34.
11. Papadaki L, Wotherspoon AC, Isaacson PG. The lymphoepithelial lesion of gastric low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT): An ultrastructural study. Histopathology 1992; 21: 415-421.
12. Isaacson PG, Du MQ. Gastrointestinal lymphoma: Where morphology meets molecular biology. J Pathol 2005; 205: 255-274.
13. Economopoulos T, Asprou N, Stathakis N et al. Primary extranodal non-Hodgkin's lymphoma of the head and neck. Oncology 1992; 49: 484-488.
14. Bertoni F, Sanna P, Tinguely M et al. Association of gastric and Waldeyer's ring lymphoma: A molecular study. Hematol Orcol 2000; 18: 15-19.
15. Elstrom R, Guan L, Baker G et al. Utility of FDG-PET scanning in lymphoma by WHO classification. Blood 2003; 101: 3875-3876.
16. Alinari L, Castellucci P, Elstrom R et al. 18F-FDG PET in mucosa-associated lymphoid tissue (MALT) lymphoma. Leuk Lymphoma 2006; 10: 2096-2101.
17. Carbone PP, Kaplan HS, Musshoff K et al. Report of the committee on Hodgkin's disease staging classification. Cancer Res 1971; 31: 1860-1861.
18. Rohatiner A, D'Amore F, Coiffier B et al. Report on a workshop convened to discuss the pathological and staging classifications of gastrointestinal tract lymphoma. Ann Oncol 1994; 5: 397-400.
19. Rouskone-Fourmerstraux A, Dragosics B, Morgner A et al. Paris staging system for primary gastrointestinal lymphomas. Gut 2003; 52: 912-913.
20. Isaacson P, Wright DH. Malignant lymphoma of mucosa-associated lymphoid tissue. A distinctive type of B-cell lymphoma. Cancer 1983; 52: 1410-1416.
21. Harris NL, Jaffe ES, Stein H et al. A revised European-American Classification of lymphoid neoplasms: A proposal from International Lymphoma Study Group. Blood 1994; 84: 1361-1392.
22. Wotherspoon AC, Ortiz-Hidalgo C, Falzon MR, Isaacson PG. Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma. Lancet 1991; 338: 1175-1176.
23. Farinha P, Gascoyne RD. Molecular pathogenesis of mucosa-associated lymphoid tissue lymphoma. J Clin Oncol 2005; 23: 6370-6378.
24. Doglioni C, Wotherspoon AC, Moschini A et al. High incidence of primary gastric lymphoma in northeastern Italy. Lancet 1992; 339: 834-835.
25. Parsonnet J, Hansen S, Rodriguez L et al. Helicobacter pylori infection and gastric lymphoma. N Engl J Med 1994; 330: 1267-1271.
26. Auer IA, Gascoyne RD, Connors JM et al. t(11;18)(q21;q21) is the most common translocation in MALT lymphomas. Ann Oncol 1997; 8: 979-985.
27. Dierlamm J, Baens M, Wlodarska I et al. The apoptosis inhibitor gene AP12 and a novel 18q gene, MLT, are recurrently rearranged in the t(11;18)(q21;q21) associated with mucosa-associated lymphoid tissue lymphomas. Blood 1999; 93: 3601-3609.
28. Akagi T, Motegi M, Tamura A et al. A novel gene, MALT1 at 18q21 is involved in t(11;18)(q21;q21) found in low-grade B-cell lymphoma of mucsa-assciated lymphoid tissue. Oncogene 1999; 18: 5785-5794.
29. Liu H, Ye H, Dogan A et al. t(11;18)(q21;q21) is associated with advanced mucosa-associated lymphoid tissue lymphoma that expresses nuclear BCL10. Blood 2001; 98: 1182-1187.
30. Liu H, Ruskon-Fourmestraux A, Lavergne-Slove A et al. Resistance of t(11;18) positive gastric mucosa-associated lymphoid tissue lymphoma to Helicobacter pylori eradication therapy. Lancet 2001; 357: 39-40.
31. Peng H, Du M, Diss TC et al. Genetic evidence for a clonal link between low and high-grade components in gastric MALT B-cell lymphoma. Histopathology 1997; 30: 425-429.
32. Bayerdorffer E, Neubauer A, Rudolph B et al. Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure of Helicobacter pylori infection. MALT Lymphoma Study Group. Lancet 1995; 345: 1591-1594.
33. Roggero E, Zucca E, Pinotti G et al. Eradication of Helicobacter pylori infection in primary low-grade gastric lymphoma of mucosa-associated lymphoid tissue. Ann Intern Med 1995; 122: 767-769.
34. Ruskone-Fourmestraux A. Gastrointestinal lymphomas: The French experience of the Groupe D'etude des Lymphomes Digestifs (GELD). Recent Results Cancer Res 2000; 156: 99-103.
35. Wundisch T, Thiede C, Morgner A et al. Long-term follow-up of gastric MALT lymphoma after Helicobacter pylori eradication. J Clin Oncol 2005; 23: 8018-8024.
36. Wundisch T, Mosch C, Neubauer A, Stolte M. Helicobacter pylori eradication in gastric mucosa-associated lymphoid tissue lymphoma: results of a 196-patient series. Leuk Lymphoma 2006; 47: 2110-2114.
37. Zucca E, Cavalli F. Are antibiotics the treatment of choice for gastric lymphomas? Curr Hematol Rep 2004; 3: 11-16.
38. Fischbach W, Goebeler ME, Ruskone-Fourmestraux A et al. Most patients with minimal histological residuals of gastric MALT lymphoma after successful eradication of Helicobacter pylori can be managed safely by a watch and wait strategy: Experience from a large international series. Gut 2007; 56: 1685-1687.
39. Thiede C, Wundisch T, Alpen B et al. Long-term persistence of monoclonal B cells after cure of Helicobacter pylori infection and complete histologic remission in gastric mucosa-associated lymphoid tissue B-cell lymphoma. J Clin Oncol 2001; 19: 1600-1609.
40. Yahalom J. MALT lymphomas: A radiation oncology viewpoint. Ann Hematol 2001; 80 (Suppl 3): B100-B105.
41. Schechter NR, Portlock CS, Yahalom J. Treatment of mucosa-associated lymphoid tissue lymphoma of the stomach with radiation alone. J Clin Oncol 1998; 16: 1916-1921.
42. Tsang RW, Gospodarowicz MK, Pintilie M et al. Localized mucosa-associated lymphoid tissue lymphoma treated with radiation therapy has excellent clinical outcome. J Clin Oncol 2003; 21: 4157-4164.
43. Nakamura S, Matsumoto T, Suekane H et al. Long-term clinical outcome of Helicobacter pylori eradication for gastric mucosa-associated lymphoid tissue lymphoma with a reference to second-line treatment. Cancer 2005; 104: 532-540.
44. Levy M, Copie-Bergman C, Gameiro C et al. Prognostic value of translocation t(11;18) in tumoral response of low-grade gastric lymphoma of mucosa-associated lymphoid tissue type to oral chemotherapy. J Clin Oncol 2005; 23: 5061-5066.
45. Jager G, Neumeister P, Brezinschek R et al. Treatment of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type with cladribine: A phase II study. J Clin Oncol 2002; 20: 3872-3877.
46. Streubel B, Ye H, Du MQ et al. Translocation t(11;18)(q21;q21) is not predictive of response to chemotherapy with 2CdA in patients with gastric MALT lymphoma. Oncology 2004; 66: 476-480.
47. Martinelli G, Laszlo D, Ferreri AJ et al. Clinical activity of rituximab in gastric marginal zone non-Hodgkin's lymphoma resistant to or not eligible for anti-Helicobacter pylori therapy. J Clin Oncol 2005; 23: 1979-1983.
48. Aviles A, Nambo MJ, Neri N et al. Mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach: Results of a controlled clinical trial. Med Oncol 2005; 22: 57-62.
49. Koch P, del Valle F, Berdel WE et al. Primary gastrointestinal non-Hodgkin's lymphoma: II. Combined surgical and conservative or conservative management only in localized gastric lymphoma - results of the prospective German Multicenter Study GIT NHL 01/92. J Clin Oncol 2001; 19: 3874-3883.
50. Raderer M, Wohrer S, Streubel B et al. Activity of rituximab plus cyclophosphamide, doxorubicin/mitoxantrone, vincristine and prednisone in patients with relapsed MALT lymphoma. Oncology 2006; 70: 411-417.
51. Bertoni F, Zouca E. State-of-the-art theraputics: Marginal zone lymphomas. J Clin Oncol 2005; 23: 6415-6420.
52. Raderer M, Wohrer S, Bartsch R et al. Phase II study of oxaliplatin for treatment of patients with mucosa-associated lymphoid tissue lymphoma. J Clin Oncol 2005; 23: 8442-8446.
53. Chan JK, Ng CS, Isaacson PG. Relationship between high-grade lymphoma and low-grade B-cell mucosa-associated lymphoid tissue lymphoma (MALToma) of the stomach. Am J Pathol 1990; 136: 1153-1164.
54. Yoshino T, Omonishi K, Kobayashi K et al. Clinicopathological features of gastric mucosa associated lymphoid tissue (MALT) lymphomas: High grade transformation and comparison with diffuse large B cell lymphomas without MALT lymphoma features. J Clin Pathol 2000; 53: 187-190.
55. Cogliatti SB, Schmid U, Schumacher U et al. Primary B-cell gastric lymphoma: A clinicopathological study of 145 patients. Gastroenterology 1991; 101: 1159-1170.
56. Ullrich A, Fischbach W, Blettner M. Incidence of gastric B-cell lymphomas: A population-based study in Germany. Ann Oncol 2002; 13: 1120-1127.
57. Freeman C, Berg JW, Cutler SJ. Occurrence and prognosis of extranodal lymphomas. Cancer 1972; 29: 252-260.
58. Ferreri AJ, Freschi M, Dell'Oro S et al. Prognostic significance of the histopathologic recognition of low- and high-grade components in stage I-II B-cell gastric lymphomas. Am J Surg Pathol 2001; 25: 95-102.
59. Wohrer S, Puspok A, Drach J et al. Rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) for treatment of early-stage gastric diffuse large B-cell lymphoma. Ann Oncol 2004; 15: 1086-1090.
60. Habermann TM, Weller EA, Morrison VA et al. Rituximab-CHOP versus CHOP alone or with maintenance rituximab in older patents with diffuse large B-cell lymphoma. J Clin Oncol 2006: 24: 3121-3127.
61. Feugler P, Van Hoof A, Sebban C et al. Long-term results of the R-CHOP study in the treatment of elderly patents with diffuse large B-cell lymphoma: A study by the Groupe d'Etude des Lymphomes de l'Adulte. J Clin Oncoll 2005; 23: 4117-4126.
62. Economopoulos T, Alexopoulos C, Stathakis N et al. Primary gastric lymphoma - the experience of a general hospital. Br J Cancer 1985; 52: 391-397.
63. Azab MB, Henry-Amar M, Rougier P et al. Prognostic factors in primary gastrointestinal non-Hodgkin's lymphoma. A multivariate analysis, report of 106 cases, and review of the literature. Cancer 1989; 64: 1208-1217.
64. Tondini C, Giardini R, Bozzetti F et al. Combined modality treatment for primary gastrointestinal non-Hodgkin's lymphoma: The Milan Cancer Institute experience. Ann Oncol 1993; 4: 831-837.
65. Tedeschi L, Romanelli A, Dallavalle G et al. Stages I and II non-Hodgkin's lymphoma of gastrointestinal tract. Retrospective analysis of 79 patients and review of the literature. J Clin Gastroenterol 1994; 18: 99-104.
66. Economopoulos T, Alexopoulos C, Stathakis N et al. Primary gastric lymphoma. Eur J Cancer 1990; 26: 855.
67. Liang R, Todd D, Chan TK et al. Prognostic factors for primary gastrointestinal lymphoma. Hematol Oncol 1995; 13: 153-163.
68. Ruskone-Fourmestraux A, Aegerter P, Delmer A et al. Primary digestive tract lymphoma: A prospective multicentric study of 91 patients. Groupe d'Etude des Lymphomes Digestifs. Gastroenterology 1993; 105: 1662-1671.
69. Morton JE, Leyland MJ, Vaughan Hudson G et al. Primary gastrointestinal non-Hodgkin's lymphoma: A review of 175 British National Lymphoma Investigation cases. Br J Cancer 1993; 67: 776-782.
70. Salles G, Herbrecht R, Tilly H et al. Aggressive primary gastrointestinal lymphoma: Review of 91 patents treated with the LNH-84 regimen. A study of the Groupe d'Etude des Lymphomes Aggressifs. Am J Med 1991; 90: 77-84.
71. Willich NA, Reinartz G, Horst EJ et al. Operatve and conservative management of primary gastric lymphoma: Interim results of a German multicenter study. Int J Radiat Oncol Biol Phys 2000; 46: 895-901.
72. Coiffier B, Salles G. Does surgery belong to medical history for gastric lymphomas? Ann Oncoll 1997; 8: 419-421.
73. Ferreri AJ, Montalban C. Primary diffuse large B-cell lymphoma of the stomach. Crit Rev Oncol Hematol 2007; 63: 65-71.
74. Aviles A, Nambo MJ, Neri N et al, The role of surgery in primary gastric lymphoma: Results of a controlled clinical trial. Ann Surg 2004; 240: 44-50.
75. Ferred AJ, Cordio S, Ponzoni M, Villa E. Non-surgical treatment with primary chemotherapy, with or without radiation therapy, of stage I-II high-grade gastric lymphoma. Leuk Lymphoma 1999; 33: 531-541.
76. Koch P, Probst A, Berdel WE et al. Treatment results in localized primary gastric lymphoma: Data of patients registered within the German multicenter study (GIT NHL 02/96). J Clin Oncol 2005; 23: 7050-7059.
77. Raderer M, Chott A, Drach J et al. Chemotherapy for management of localised high-grade gastric B-cell lymphoma: How much is necessary? Ann Oncol 2002; 13: 1094-1098.
78. Morgner A, Miehlke S, Fischbach W et al. Complete remission of primary highgrade B-cell gastric lymphoma after cure of Helicobacter pylori infection. J Clin Oncol 2001; 19: 2041-2048.
79. Chen LT, Lin JT, Shyu RY et al. Prospective study of Helicobacter pylori eradication therapy in stage I(E) high-grade mucosa-associated lymphoid tissue lymphoma of the stomach. J Clin Oncol 2001; 19: 4245-4251.