• Journal of Digestive Cancer Research
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• 제3권2호
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• pp.82-88
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• 2015

위에 발생하는 암 중 위 림프종이 1-6% 가량을 차지하고 있고, 이 중 50% 가량이 MALT 림프종이다. MALT 림프종의 60-70% 가량은 조기, 국소병기에서 진단된다. 위 MALT 림프종은 일반적으로 그 진행이 매우 느리며 상복부 통증, 소화불량, 오심, 구토 등의 비특이적인 증상을 보인다. 진단은 조직학적으로 진단하며, 헬리코박터필로리 연관 만성 위염에서 보이는 염증성 병변과의 감별을 위해 Wotherspoon score를 이용한다. 여러 연구를 통해 위 MALT 림프종이 헬리코박터필로리 감염과 관련이 있다는 것이 밝혀져 있고, 3세염색체증, 18세염색체증, t(11;18), t(1;14), t(14;18), t(3;14) 등 여러 유전적 이상을 가질 수 있는 것으로 알려져 있다. 적절한 치료 방침을 결정하기 위해 병기를 결정하는 것은 매우 중요하며, Lugano International Conference classification을 주로 사용한다. 위 MALT 림프종의 1차 치료는 헬리코박터필로리 감염 유무 및 병기와 관계없이 헬리코박터필로리 제균치료이다. Stage I/II1 환자의 경우 제균치료로 60-90%의 완전 완화율을 보인다. 제균치료에 반응이 없는 경우에는 방사선치료, 항암화학요법, 면역치료 등을 시행해 볼 수 있고, 75-100%의 완전완화율을 보인다. 향후 헬리코박터필로리의 감염율이 감소하면서 위 MALT 림프종의 발생도 감소할 것으로 기대된다. 또한 향후 치료방침 확립을 위해 지속적인 연구가 필요할 것으로 생각한다.

• Journal of Korean Neurosurgical Society
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• 제51권6호
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• pp.377-379
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• 2012

Mucosa-associated lymphoid tissue (MALT) lymphoma is one of the most common lymphomas and accounts for about 7% of all newly diagnosed non-Hodgkin's lymphoma (NHL). The clinical course of MALT lymphoma is relatively indolent and, in the majority of cases (50%), the lymphoma arises within the stomach. Primary central nervous system lymphoma (PCNSL), an uncommon variant of extranodal NHL, can affect any part of the neuraxis, including the eyes, brain, leptomeninges, or spinal cord. Herein, we present a rare case of PCNSL, which occurred one year after radiochemotherapy of gastric MALT lymphoma. A 62-year-old man presented with a 3-day history of left facial palsy. One year ago, he underwent antibiotic eradication therapy of Helicobacter pylori, local stomach fractional radiotherapy, and chemotherapy for gastric MALT lymphoma. Magnetic resonance imaging revealed a strong enhancing solid mass in the right frontal lobe. The tumor was completely removed, and the histological diagnosis of PCNSL developing from diffuse large B-cell lymphoma was made. Although elucidating the correlation between the first gastric MALT lymphoma and the second PCNSL seemed difficult, we have postulated and discussed some possible pathogeneses, together with a review of literature.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권2호
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• pp.187-192
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• 2008

만성 복통을 주소로 내원한 12세 여아에서 내시경 소견상 결절성 위염과 조직 검사상 H. pylori 감염을 확인 하였으며, 병리 소견 및 면역조직화학 검사상 위 MALT 림프종으로 진단되어, H. pylori 제균 치료 후 결절성 위염의 호전과 위 MALT 림프종의 완전한 관해를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대한임상검사과학회지
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• 제46권3호
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• pp.91-98
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• 2014

Primary gastric lymphoma (PGL) is derived from mucosa-associated lymphoid tissue (MALT) and it differs from nodal lymphoma in histologic features and biologic behavior. Recent studies have showed that Helicobacter pylori (H.pylori ) infection is closely related to the development of low grade gastric lymphoma, and eradication of the infection induces regression of the tumor. H. pylori infection is known to be important to the development of gastric MALT lymphoma. The aim of this study was to elucidate the histopathological behavior of PGL according to the concept of MALT and to compare the predictive value of tests frequently used for diagnosis of H. pylori. The histological features of gastric lymphoma arising from MALT are the replacement of glands by uniform dense infiltration of centrocyte-like cells in the lamina propria and lymphoidepithelial lesion. H. pylori-associated histologic changes of neutrophilic infiltration, lymphoid follicle or aggregates formation and intestinal metaplasia, and H. pylori immunoreactivity were analyzed. Detection of H. pylori in chronic active gastritis and peptic ulcer suggests a possible role of H. pylori in the pathogenesis. Giemsa, Toluidine blue and Long H&E stains were used in H. pylori detection. Histopathological examination of gastric biopsy specimens revealed lymphoepithelial lesions pathognomonic of MALT lymphoma, and immunohistochemical staining for CD20 was diffusely positive. CD3 was positive in reactive T cells. PAX-5 was negative except the follicle. Bcl-2, cytokeratin, Ki-67, and c-myc were positive. The findings may indicate a predictable transition of low grade to high grade, and c-myc may be used as a valuable marker before molecular pathology diagnosis.

• Journal of Yeungnam Medical Science
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• 제36권2호
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• pp.85-91
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• 2019

The incidence of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is increasing worldwide, but the diagnosis is difficult. Most patients are asymptomatic or complain of nonspecific gastrointestinal symptoms. As the endoscopic features of gastric MALT lymphoma are variable and nonspecific, the possibility of this condition may be overlooked during esophagogastroduodenoscopy, and it remain undiagnosed. Therefore, this condition needs to be considered when an abnormal mucosa is observed during this procedure. Biopsy performed during endoscopy is the primary diagnostic test, but false negative results are possible; large numbers of samples should be collected from both normal and abnormal mucosae. Endoscopic ultrasonography is useful to assess the depth of invasion and to predict the treatment response. After treatment, follow-up tests are required every 3 months until complete remission is achieved, and annually thereafter. Early diagnosis of gastric MALT lymphoma is difficult, and its diagnosis and follow-up require wide experience and competent endoscopic technique.

• Journal of Yeungnam Medical Science
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• 제39권1호
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• pp.3-11
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• 2022

Lymphoma is the most common primary tumor of the orbit, accounting for 55% of all orbital malignancies. When divided into histopathological subtypes, extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) comprises the largest proportion. Clinical manifestations are unspecific, but in patients with slow-growing painless orbital mass, or red conjunctival lesion suggestive of 'salmon patch', ocular adnexa lymphoma (OAL) should be suspected. Although the pathogenetic mechanism of ocular adnexal MALT lymphoma (OAML) is not yet fully understood, the relationship between OAML and Chlamydia psittaci has been hypothesized recently, similar to that between gastric MALT lymphoma and Helicobacter pylori. This suggests a new treatment option for OAML; bacterial eradication therapy with systemic antibiotics. Several other treatment methods for OAML have been introduced, but no treatment guidelines have been established yet. In this article, we summarize the current knowledge on the clinical features, pathogenesis, diagnostic methods, therapeutic strategies, and prognosis of OAML.

• BLOOD RESEARCH
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• 제53권4호
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• pp.329-332
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• 2018

• 대한위암학회:학술대회논문집
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• 대한위암학회 2002년도 제13회 춘계학술대회
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• pp.18-23
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• 2002

• Journal of Gastric Cancer
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• 제1권1호
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• pp.60-63
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• 2001

Purpose: The aim of this study was to analyze the clinical and the histopathological characteristics of mucosa associated lymphoid tissue (MALT) lymphomas in the stomach. Materials and Methods: We retrospectively reviewed the medical records of 22 patients who had been treated at Samsung Medical Center from Jan. 1995 to Sep. 2000 and who had been pathologically proven to have a MALT lymphoma. The factors we analyzed were operative procedure, tumor stage, and histopathological characteristics. Results: Of 3658 patients with a gastric malignancy, 22 patients proved to have a MALT lymphoma ($0.6\%$). There were 7 men and 15 women whose ages ranged from 25 years to 70 years (mean, 48.8 years). Forteen cases were located in the antrum, 4 ($18\%$) in the body and 4 ($18\%$) in the fundus or the high body. Nineteen of these patients were managed with total gastrectomy and splenectomy and 3 with radical subtotal gastrectomy. Histopathologically the tumor was limited to the mucosa in 3 patients ($1.36\%$), to the submucosa in 13 ($59.1\%$) and extended to the muscularis propria in 6 ($27.3\%$). Lymph node involvement was seen in 12 patients ($54.6\%$). There was no splenic or hepatic involvement. Bone marrow involvement was not seen in any patients. H. pylori was identified in 11 patients (50$\%$). During the mean follow-up period of 32.7 months, there were no reports of tumor recurrence or death. Conclusion: MALT lymphomas rarely disseminate by the time of diagnosis and rarely involve the bone marrow. Lymph node involvement is relatively high and a total gastrectomy is effective in managing patients with a MALT lymphoma.

• Radiation Oncology Journal
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• 제34권3호
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• pp.193-201
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• 2016

Purpose: To assess the clinical outcomes of radiotherapy (RT) using two-dimensional (2D) and three-dimensional conformal RT (3D-CRT) for patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma to evaluate the effectiveness of involved field RT with moderate-dose and to evaluate the benefit of 3D-CRT comparing with 2D-RT. Materials and Methods: Between July 2003 and March 2015, 33 patients with stage IE and IIE gastric MALT lymphoma received RT were analyzed. Of 33 patients, 17 patients (51.5%) were Helicobacter pylori (HP) negative and 16 patients (48.5%) were HP positive but refractory to HP eradication (HPE). The 2D-RT (n = 14) and 3D-CRT (n = 19) were performed and total dose was 30.6 Gy/17 fractions. Of 11 patients who RT planning data were available, dose-volumetric parameters between 2D-RT and 3D-CRT plans was compared. Results: All patients reached complete remission (CR) eventually and median time to CR was 3 months (range, 1 to 15 months). No local relapse occurred and one patient died with second primary malignancy. Tumor response, survival, and toxicity were not significantly different between 2D-RT and 3D-CRT (p > 0.05, each). In analysis for dose-volumetric parameters, $D_{max}$ and CI for PTV were significantly lower in 3D-CRT plans than 2D-RT plans (p < 0.05, each) and $D_{mean}$ and V15 for right kidney and $D_{mean}$ for left kidney were significantly lower in 3D-CRT than 2D-RT (p < 0.05, each). Conclusion: Our data suggested that involved field RT with moderate-dose for gastric MALT lymphoma could be promising and 3D-CRT could be considered to improve the target coverage and reduce radiation dose to the both kidneys.