Helicobacter suis infection is associated with nodular gastritis‐like appearance of gastric mucosa‐associated lymphoid tissue lymphoma

• Published in: Cancer medicine (Malden, MA) MA), 2019-08, Vol.8 (9), p.4370-4379
• Main Authors: Takigawa, Hidehiko, Masaki, Satoshi, Naito, Toshikatsu, Yuge, Ryo, Urabe, Yuji, Tanaka, Shinji, Sentani, Kazuhiro, Matsuo, Taiji, Matsuo, Keisuke, Chayama, Kazuaki, Kitadai, Yasuhiko
• Format: Article
• Language: English
• Subjects: Adult; Amoxicillin - pharmacology; Amoxicillin - therapeutic use; Biopsy; Cancer Biology; Clarithromycin - pharmacology; Clarithromycin - therapeutic use; Deoxyribonucleic acid; DNA; DNA, Bacterial - genetics; Drug Therapy, Combination; Endoscopy; Eradication; eradication therapy; Gastric mucosa; Gastritis; Gastritis - drug therapy; Gastritis - microbiology; Helicobacter heilmannii - drug effects; Helicobacter heilmannii - genetics; Helicobacter heilmannii - isolation & purification; Helicobacter Infections - diagnosis; Helicobacter Infections - drug therapy; Helicobacter Infections - epidemiology; Helicobacter pylori; Helicobacter suis; Humans; Infections; Lansoprazole - pharmacology; Lansoprazole - therapeutic use; Lymphoid tissue; Lymphoma; Lymphoma, B-Cell, Marginal Zone - drug therapy; Lymphoma, B-Cell, Marginal Zone - microbiology; Male; Middle Aged; Mucosal-associated lymphoid tissue; mucosa‐associated lymphoid tissue; nodular gastritis; non‐H pylori Helicobacter (NHPH); Original Research; Paraffin; Pathogenesis; Phenotypes; Polymerase chain reaction; Prevalence; Treatment Outcome; Variance analysis
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.2314

Most patients with gastric mucosa‐associated lymphoid tissue (MALT) lymphoma are infected with Helicobacter pylori, and eradication therapy is the first‐line treatment for localized disease with H pylori infection. However, there were several reports showing effectiveness of eradication therapy in even H pylori negative cases. Gastric MALT lymphomas are endoscopically classified into three common types: superficial, ulcerative, and elevated types. For the past 20 years, we have encountered 200 cases of localized gastric MALT lymphoma. Among them, only 4 cases (2%) showed similar macroscopic findings to those of nodular gastritis (gastric MALT lymphoma with nodular gastritis‐like appearance; M‐NGA). Here, we compared clinicopathological characteristics and prevalence of non‐H pylori Helicobacter (NHPH) infection between M‐NGA and other common types of gastric MALT lymphoma. To examine the prevalence of NHPH infection, DNA was extracted from formalin‐fixed paraffin‐embedded biopsy tissues from four cases of M‐NGA, 20 cases of common endoscopic types of gastric MALT lymphoma, and 10 cases of nodular gastritis. We used a highly sensitive polymerase chain reaction assay to detect the presence of five species of NHPH (Helicobacter suis, H felis, H bizzozeronii, H salomonis, and H heilmannii). H suis infection was detected in 4, 2, and 0 of the 4, 20, and 10 cases of M‐NGA, other types of gastric MALT lymphoma, and nodular gastritis, respectively. Other NHPH species were not detected in any cases. Complete response rate by eradication therapy was 4/4 in M‐NGA cases. Therefore, nodular gastritis‐like MALT lymphoma, which shows a very rare phenotype, is closely associated with NHPH infection, and eradication therapy may be the first‐choice treatment. In this study, we compared clinicopathological characteristics and prevalence of non‐Helicobacter pylori Helicobacter (NHPH) infection between common type mucosa‐associated lymphoid tissue (MALT) lymphoma and MALT lymphoma with nodular gastritis‐like appearance (M‐NGA). H suis infection was detected in 4/4 cases of M‐NGA. Our study indicates that NHPH infection may be one of the causes of the pathogenesis of M‐NGA and that eradication therapy should be the first‐choice treatment for M‐NGA associated with NHPH infection.