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Synchronous gastric MALT lymphoma and gastric adenocarcinoma of fundic gland type arising from a hamartomatous inverted polyp in a Helicobacter pylori naive patient

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Abstract

We present a rare case that showed the coexistence of gastric cancer and mucosa-associated lymphoid tissue (MALT) lymphoma in Helicobacter pylori-naive stomach. A 72-year-old man was followed up after surgery for epithelial carcinoma of the glottis at the Department of Otolaryngology. He underwent an upper gastrointestinal endoscopy for an abnormal PET-CT accumulation, which revealed gastric adenocarcinoma of fundic gland type in the gastric fundus and MALT lymphoma in the upper gastric body. Hence, we performed an endoscopic submucosal dissection for gastric cancer and diagnosed gastric adenocarcinoma of fundic gland type derived from a hamartomatous–inverted polyp. Subsequently, Gastric MALT lymphoma was treated with radiation therapy because the API2-MALT1 gene was positive and the Helicobacter pylori infection was negative. A complete response was observed. Even in Hp-naive stomachs, cases such as the present case are complicated by special types of gastric cancer and MALT lymphoma, and endoscopic examination should be performed with these diseases in mind.

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References

  1. Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345:784–9.

    Article  CAS  PubMed  Google Scholar 

  2. Matsuo T, Ito M, Takata S, et al. Low prevalence of Helicobacter pylori-negative gastric cancer among Japanese. Helicobacter. 2011;16:415–9.

    Article  PubMed  Google Scholar 

  3. Ueyama H, Yao T, Nakashima Y, et al. Gastric adenocarcinoma of fundic gland type (chief cell predominant type): proposal for a new entity of gastric adenocarcinoma. Am J Surg Pathol. 2010;34:609–19.

    Article  PubMed  Google Scholar 

  4. Isaacson PG, Wright DH. Malignant lymphoma of mucosa-associated lymphoid tissue A distinctive type of B-cell lymphoma. Cancer. 1983;52:1410–6.

    Article  CAS  PubMed  Google Scholar 

  5. Wotherspoon AC, Doglioni C, Diss TC, et al. Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradication of Helicobacter pylori. Lancet. 1993;342:575–7.

    Article  CAS  PubMed  Google Scholar 

  6. Nakamura S, Sugiyama T, Matsumoto T, et al. Long–term clinical outcome of gastric MALT lymphoma after eradication of Helicobacter pylori: a multicentre cohort follow–up study of 420 patients in Japan. Gut. 2012;61:507–13.

    Article  PubMed  Google Scholar 

  7. Ishihama T, Kondo H, Saito D, et al. Clinicopathological studies on coexisting gastric malignant lymphoma and gastric adenocarcinoma: report of four cases and review of the Japanese literature. Jpn J Clin Oncol. 1997;27:101–6.

    Article  CAS  PubMed  Google Scholar 

  8. Sakai T, Ogura Y, Narita J, et al. Simultaneous early adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach associated with Helicobacter pylori infection. Gastric Cancer. 2003;6:191–6.

    Article  PubMed  Google Scholar 

  9. Shiota S, Murakawi K, Suzuki R, et al. Helicobacter pylori infection in Japan. Expert Rev Gastroenterol Hepatol. 2013;7:35–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Takigawa H, Yuge R, Masaki S, et al. Involvement of non-Helicobacter pylori helicobacter infections in Helicobacter pylori-negative gastric MALT lymphoma pathogenesis and efficacy of eradication therapy. Gastric Cancer. 2021;24:937–45.

    Article  CAS  PubMed  Google Scholar 

  11. Asano N, Iijima K, Koike T, et al. Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue lymphomas: a review. World J Gastroenterol. 2015;21:8014–20.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Noda T, Akashi H, Matsueda S, et al. Collision of malignant lymphoma and multiple early adenocarcinomas of the stomach. Arch Pathol Lab Med. 1989;113:419–22.

    CAS  PubMed  Google Scholar 

  13. Nakamura S, Aoyagi K, Iwanaga S, et al. Synchronous and metachronous primary gastric lymphoma and adenocarcinoma: a clinicopathological study of 12 patients. Cancer. 1997;79:1077–85.

    Article  CAS  PubMed  Google Scholar 

  14. Hamabe A, Omori T, Oyama T, et al. A Helicobacter pylori infection complicated with gastric cancer, gastric mucosa-associated lymphoid tissue lymphoma, and idiopathic thrombocytopenic purpura was successfully treated with laparoscopy-assisted total gastrectomy and splenectomy. Asian J Endosc Surg. 2011;4:32–5.

    Article  CAS  PubMed  Google Scholar 

  15. Suenaga M, Ohta K, Toguchi M, et al. Colliding gastric and intestinal phenotype well-differentiated adenocarcinoma of the stomach developing in an area of MALT-type lymphoma. Gastric Cancer. 2003;6:270–6.

    Article  PubMed  Google Scholar 

  16. Akiba J, Nakane T, Arakawa F, et al. Collision of EBV-associated gastric carcinoma and primary gastric extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue in the remnant stomach. Pathol Int. 2010;60:102–6.

    Article  CAS  PubMed  Google Scholar 

  17. Kanamoto K, Aoyagi K, Nakamura S, et al. Simultaneous coexistence of early adenocarcinoma and low-grade MALT lymphoma of the stomach associated with Helicobacter pylori infection: a case report. Gastrointest Endosc. 1998;47:73–5.

    Article  CAS  PubMed  Google Scholar 

  18. Raderer M, Streubel B, Wöhrer S, et al. Metachronous gastric MALT lymphoma and early gastric cancer. Ann Oncol. 2006;17:724.

    Article  CAS  PubMed  Google Scholar 

  19. Raderer M, Püspök A, Stummvoll G, et al. Early cancer of the stomach arising after successful treatment of gastric MALT lymphoma in patients with autoimmune disease. Scand J Gastroenterol. 2003;38:294–7.

    Article  CAS  PubMed  Google Scholar 

  20. Amiot A, Jooste V, Gagniere C, et al. Second primary malignancies in patients treated for gastric mucosa-associated lymphoid tissue lymphoma. Leuk Lymphoma. 2017;58:2057–64.

    Article  Google Scholar 

  21. Imamura K, Yao K, Nimura S, et al. Characteristic endoscopic findings of gastric adenocarcinoma of fundic-gland mucosa type. Gastric Cancer. 2021;24:1307–19.

    Article  CAS  PubMed  Google Scholar 

  22. Yamashita M, Hirokawa M, Nakasono M, et al. Gastric inverted hyperplastic polyp Report of four cases and relation to gastritis cystica profunda. APMIS. 2002;110:717–23.

    Article  PubMed  Google Scholar 

  23. Yu XF, Guo LW, Chen ST, et al. Gastritis cystica profunda in a previously unoperated stomach: a case report. World J Gastroenterol. 2015;21:3759–62.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Gurzu S, Sugimura H, Orlowska J, et al. New insights in histogenetic pathways of gastric cancer. Med (Baltim). 2015;94:e1810.

    Article  Google Scholar 

  25. Takahashi K, Fujiya M, Ichihara S, et al. Inverted gastric adenocarcinoma of fundic gland mucosa type colliding with well-differentiated adenocarcinoma: case a report. Medicine. 2017;96:e7080.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Okamura T, Iwaya Y, Nagaya T, et al. Gastric adenocarcinoma arising from hamartomatous–inverted polyp during 8-year follow-up. DEN Open. 2022;2:e16.

    Article  PubMed  Google Scholar 

  27. Yamamoto M, Nishida T, Nakamatsu D, et al. Endoscopic findings of inverted pyloric gland adenoma resected by endoscopic submucosal dissection. J Gastrointestin Liver Dis. 2018;27:361.

    Article  PubMed  Google Scholar 

  28. Kim GH, Lee MW, Lee BE, et al. Endoscopic submucosal dissection of an inverted pyloric gland adenoma using dental floss and clip traction. Clin Endosc. 2021;54:935–6.

    Article  PubMed  Google Scholar 

  29. Kushima R, Sekine S, Matsubara A, et al. Gastric adenocarcinoma of the fundic gland type shares common genetic and phenotypic features with pyloric gland adenoma. Pathol Int. 2013;63:318–25.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

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Authors and Affiliations

  1. Department of Endoscopy, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan

    Ryo Miyamoto, Hidehiko Takigawa, Takahiro Kotachi, Hiroki Kadota, Ryo Yuge & Ryohei Hayashi

  2. Department of Gastroenterology, Hiroshima University Hospital, Hiroshima, 734-8553, Japan

    Shiro Oka

  3. Department of Gastrointestinal Endoscopy and Medicine, Hiroshima University Hospital, Hiroshima, Japan

    Yuji Urabe

  4. Department of Molecular Pathology, Hiroshima University Hospital, Hiroshima, Japan

    Akira Ishikawa & Kazuhiro Sentani

Authors
  1. Ryo Miyamoto
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  2. Hidehiko Takigawa
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  3. Takahiro Kotachi
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  4. Hiroki Kadota
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  5. Ryo Yuge
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  6. Ryohei Hayashi
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  8. Akira Ishikawa
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  9. Kazuhiro Sentani
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  10. Shiro Oka
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Contributions

All the authors contributed to the conception and design of the study. The first draft of the manuscript was written by Ryo Miyamoto, and all the authors commented on the previous versions of the manuscript. All authors have read and approved the final manuscript.

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Correspondence to Hidehiko Takigawa.

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Miyamoto, R., Takigawa, H., Kotachi, T. et al. Synchronous gastric MALT lymphoma and gastric adenocarcinoma of fundic gland type arising from a hamartomatous inverted polyp in a Helicobacter pylori naive patient. Clin J Gastroenterol 16, 521–526 (2023). https://doi.org/10.1007/s12328-023-01808-8

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  • DOI: https://doi.org/10.1007/s12328-023-01808-8

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