Characteristics of magnified endoscopic images of gastric extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue, including changes after treatment

Background The utility of magnifying endoscopy for diagnosis of epithelial tumors has been reported, but there are few reports for nonepithelial tumors. Objective To determine the characteristics of magnified images of gastric extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) before and after treatment. Design This was a retrospective study. Setting Endoscopy Unit, Hokkaido University Hospital. Patients Eleven patients diagnosed with MALT lymphoma were enrolled. Interventions The microstructural pattern, collecting venules, and abnormal vessels in gastric MALT lymphoma were assessed before treatment and at 4 to 7 months after treatment by using magnifying endoscopy. Main Outcome Measurement and Results The characteristics of magnified endoscopic images before treatment were the disappearance of gastric pits and the appearance of abnormal vessels. Ten cases of Helicobacter pylori –infected MALT lymphoma were treated by H pylori eradication, and 1 H pylori –negative case was treated by radiation therapy after eradication therapy. Ten patients achieved complete disease remission. After the treatment, recovery of gastric pits and subepithelial capillary network, and the disappearance of abnormal vessels were revealed by magnifying endoscopy. Limitation This was a small pilot study. Conclusions Magnified findings of gastric MALT lymphoma before and after therapy seem to correlate with complete response and no response.