Sistema Gastrointestinal e Digestivo

Abstrato

Complete Histopathological Disappearance of Rectal Malt Lymphoma after Eradication of Helicobacter pylori Confirmed by ESD

Jun Arimoto, Takuma Higurashi, Atsushi Nakajima

In a 77-year-old Japanese housewife who was undergoing regular colonoscopy for follow-up of a colon polyp, a total colonoscopy showed an elevated lesion in the rectum. Histological findings of a conventional biopsy from the lesion showed a mucosa-associated lymphoid tissue (MALT) lymphoma, and the patient was diagnosed as having clinical stage 1 disease. We elected to administer antibiotic therapy as the serological test for anti-Helicobacter pylori antibody was positive and Helicobacter pylori was detected in a culture of the biopsy specimens. The antibiotic therapy was successful, however, colonoscopy after the eradication therapy showed a residual lesion. Histologic examination can’t deny the possibility of the presence of a residual MALT lymphoma. Endoscopic ultrasonography revealed that the lesion was confined to the mucosa. We performed endoscopic submucosal dissection (ESD) and histological examination of the ESD specimen showed complete disappearance of the tumor. The patient remains in complete remission now, 1 year after the treatment.