Helicobacter pylori Reinfection Diagnosed by Endoscopic and Histologic Recurrence in a Patient with Gastric Mucosa-Associated Lymphoid Tissue Lymphoma

Toshiro Sugiyama; Sohachi Nanjyo; Takahiko Nakajima; Chieko Kato

doi:10.1159/000528309

Helicobacter pylori Reinfection Diagnosed by Endoscopic and Histologic Recurrence in a Patient with Gastric Mucosa-Associated Lymphoid Tissue Lymphoma

Case Rep Gastroenterol. 2023 Jan 10;17(1):41-48. doi: 10.1159/000528309. eCollection 2023 Jan-Dec.

Authors

Toshiro Sugiyama¹, Sohachi Nanjyo², Takahiko Nakajima³, Chieko Kato⁴

Affiliations

¹ Advanced Research Center, Health Sciences University of Hokkaido, Ishikari, Japan.
² Department of Gastroenterology, University of Toyama Graduate School of Medicine, Toyama, Japan.
³ Division of Pathology, Tonami Municipal Hospital, Tonami, Japan.
⁴ Division of Gastroenterology, Morioka Municipal Hospital, Morioka, Japan.

Abstract

Helicobacter pylori infection is a major cause of gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Successful H. pylori eradication can induce a complete remission (CR); however, it takes a long time. In this case, the recurrence of gastric MALT lymphoma was observed by endoscopic and histologic findings during a 11-year follow-up and due to H. pylori reinfection twice. After the first successful eradication and achieving histologic CR, the patient was starting to work at a nursing home for older adults, where she frequently came in contact with their vomitus or feces. In the examinations 2 years later after the first successful eradication, endoscopic and histologic findings have demonstrated deterioration. Similar findings were continuously observed in the examinations 3 months later, and H. pylori reinfection was confirmed by the rapid urease test. After the second successful eradication, endoscopic and histologic CR of gastric MALT lymphoma was achieved. However, endoscopic and histologic findings have shown deterioration again 1 year later after the histologic CR and at 3.5 years later after the second successful eradication. H. pylori reinfection was confirmed by the repeated urea breath test, and the patient had received the third eradication treatment; and the patient had achieved successful eradication. In addition, proper hygiene practices were advised to avoid H. pylori reinfection. H. pylori reinfection is very rare in adults after successful eradication in developed countries. After successful eradication and proper hygiene practice, endoscopic and histologic CR has been maintained for 2 years up to the present.

Keywords: Gastric mucosa-associated lymphoid tissue lymphoma; Helicobacter pylori reinfection; Histologic recurrence; Nursing home.

Publication types

Case Reports

Grants and funding

This work was partially supported by a Health Labor Sciences Research Grant (T.S., No.19HA1007 and No. 21HA1005 by the Japanese Government). The role of this grant is to establish a national monitoring system for antibiotic resistance to H. pylori treatment in Japan. Therefore, the funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.