Gastric MALT Lymphoma with Giant Ulcer from Untreated H. pylori: Role of Endoscopic Biopsy – A Case Report.
Introduction: Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a rare extranodal non-Hodgkin lymphoma strongly linked to Helicobacter pylori infection. It often presents with nonspecific symptoms like dyspepsia, nausea, and epigastric pain and can mimic other gastric pathologies, such as...
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Albanian Society for Trauma and Emergency Surgery
2025-01-01
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| Series: | Albanian Journal of Trauma and Emergency Surgery |
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| Online Access: | http://journal.astes.org.al/AJTES/index.php/AJTES/article/view/437 |
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| author | Hysni Dede Rovena Roshi Gentiana Cekodhima Manjola Tahiraj Augusto Orlandi |
| author_facet | Hysni Dede Rovena Roshi Gentiana Cekodhima Manjola Tahiraj Augusto Orlandi |
| author_sort | Hysni Dede |
| collection | DOAJ |
| description | Introduction: Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a rare extranodal non-Hodgkin lymphoma strongly linked to Helicobacter pylori infection. It often presents with nonspecific symptoms like dyspepsia, nausea, and epigastric pain and can mimic other gastric pathologies, such as peptic ulcers or gastric cancer.
This case report is significant as it highlights the importance of thorough biopsy procedures in diagnosing gastric MALT lymphoma. The patient presented with complaints of dyspepsia, nausea, and epigastralgia and had a giant ulcer on endoscopy. Only after biopsies with a large number of samples (over 10) from both normal and abnormal mucosa the diagnosis of MALT lymphoma was established and reconfirmed after immunohistochemistry. The presence of Helicobacter pylori was detected, and after its eradication treatment, the ulcer was more minor and improved from Forrest II-c to III. This case underscores the potential for a wrong diagnosis (undiagnosed MALT-Lymphoma) if biopsy samples are not comprehensive. It also emphasizes the need for suspicion of gastric MALT-Lymphoma and the necessity of more invasive tissue biopsy, such as EUS-FNA, EMR, and ESD, when suspicion persists.
Conclusion: Early diagnosis of gastric MALT lymphoma requires multiple biopsy samples during the initial endoscopy to prevent false negatives. Immunohistochemistry is essential for confirmation, and advanced techniques like EUS-FNA, EMR, or ESD play a significant role when suspicion persists. Timely H. pylori eradication can lead to ulcer healing and better outcomes. Proper endoscopist training is critical to reduce diagnostic delays.
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| format | Article |
| id | doaj-art-8e213d2bccda45ec9873570dbf76820f |
| institution | Kabale University |
| issn | 2521-8778 2616-4922 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Albanian Society for Trauma and Emergency Surgery |
| record_format | Article |
| series | Albanian Journal of Trauma and Emergency Surgery |
| spelling | doaj-art-8e213d2bccda45ec9873570dbf76820f2025-01-19T14:24:39ZengAlbanian Society for Trauma and Emergency SurgeryAlbanian Journal of Trauma and Emergency Surgery2521-87782616-49222025-01-019110.32391/ajtes.v9i1.437Gastric MALT Lymphoma with Giant Ulcer from Untreated H. pylori: Role of Endoscopic Biopsy – A Case Report.Hysni Dede0Rovena Roshi1Gentiana Cekodhima2Manjola Tahiraj3Augusto Orlandi4German Hospital International, Tirana, AlbaniaHealth Care Services Operator, Tirana, AlbaniaLA VITA Medical Center, Tirana, AlbaniaOur Lady of Good Counsel Catholic Hospital, Tirana, AlbaniaOur Lady of Good Counsel Catholic Hospital, Tirana, AlbaniaIntroduction: Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a rare extranodal non-Hodgkin lymphoma strongly linked to Helicobacter pylori infection. It often presents with nonspecific symptoms like dyspepsia, nausea, and epigastric pain and can mimic other gastric pathologies, such as peptic ulcers or gastric cancer. This case report is significant as it highlights the importance of thorough biopsy procedures in diagnosing gastric MALT lymphoma. The patient presented with complaints of dyspepsia, nausea, and epigastralgia and had a giant ulcer on endoscopy. Only after biopsies with a large number of samples (over 10) from both normal and abnormal mucosa the diagnosis of MALT lymphoma was established and reconfirmed after immunohistochemistry. The presence of Helicobacter pylori was detected, and after its eradication treatment, the ulcer was more minor and improved from Forrest II-c to III. This case underscores the potential for a wrong diagnosis (undiagnosed MALT-Lymphoma) if biopsy samples are not comprehensive. It also emphasizes the need for suspicion of gastric MALT-Lymphoma and the necessity of more invasive tissue biopsy, such as EUS-FNA, EMR, and ESD, when suspicion persists. Conclusion: Early diagnosis of gastric MALT lymphoma requires multiple biopsy samples during the initial endoscopy to prevent false negatives. Immunohistochemistry is essential for confirmation, and advanced techniques like EUS-FNA, EMR, or ESD play a significant role when suspicion persists. Timely H. pylori eradication can lead to ulcer healing and better outcomes. Proper endoscopist training is critical to reduce diagnostic delays. http://journal.astes.org.al/AJTES/index.php/AJTES/article/view/437Gastric MALT lymphomaHelicobacter pylorigiant gastric ulcerendoscopic biopsyimmunohistochemistry |
| spellingShingle | Hysni Dede Rovena Roshi Gentiana Cekodhima Manjola Tahiraj Augusto Orlandi Gastric MALT Lymphoma with Giant Ulcer from Untreated H. pylori: Role of Endoscopic Biopsy – A Case Report. Albanian Journal of Trauma and Emergency Surgery Gastric MALT lymphoma Helicobacter pylori giant gastric ulcer endoscopic biopsy immunohistochemistry |
| title | Gastric MALT Lymphoma with Giant Ulcer from Untreated H. pylori: Role of Endoscopic Biopsy – A Case Report. |
| title_full | Gastric MALT Lymphoma with Giant Ulcer from Untreated H. pylori: Role of Endoscopic Biopsy – A Case Report. |
| title_fullStr | Gastric MALT Lymphoma with Giant Ulcer from Untreated H. pylori: Role of Endoscopic Biopsy – A Case Report. |
| title_full_unstemmed | Gastric MALT Lymphoma with Giant Ulcer from Untreated H. pylori: Role of Endoscopic Biopsy – A Case Report. |
| title_short | Gastric MALT Lymphoma with Giant Ulcer from Untreated H. pylori: Role of Endoscopic Biopsy – A Case Report. |
| title_sort | gastric malt lymphoma with giant ulcer from untreated h pylori role of endoscopic biopsy a case report |
| topic | Gastric MALT lymphoma Helicobacter pylori giant gastric ulcer endoscopic biopsy immunohistochemistry |
| url | http://journal.astes.org.al/AJTES/index.php/AJTES/article/view/437 |
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