J Korean Neurosurg Soc.  2012 Jun;51(6):377-379. 10.3340/jkns.2012.51.6.377.

Gastric Mucosa-Associated Lymphoid Tissue Lymphoma Followed by Primary Central Nervous System Lymphoma

• Eom KS
• Park MR
• Choi KH
• Kim TY

• KMID: 2190495
• DOI: http://doi.org/10.3340/jkns.2012.51.6.377

Abstract

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.

Keyword

MALT Lymphoma; Diffuse large B-Cell lymphoma

MeSH Terms

Brain
Central Nervous System
Chemoradiotherapy
Eye
Facial Paralysis
Frontal Lobe
Helicobacter pylori
Humans
Lymphoid Tissue
Lymphoma
Lymphoma, B-Cell
Lymphoma, B-Cell, Marginal Zone
Lymphoma, Non-Hodgkin
Magnetic Resonance Imaging
Middle Aged
Spinal Cord
Stomach

Figure

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  Fig. 1 Histopathologic findings of stomach specimen. A : Lymphoepithelial lesions (arrows) typical for mucosa-associated lymphoid tissue lymphoma are defined as infiltration of the glandular epithelium by clusters of neoplastic lymphoid cells with associated destruction of gland architecture. B : Immunostaining for cytokeratin highlights lymphoepithelial lesions (arrows).

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  Fig. 2 A : Gadolium-enhanced T1-weighted magnetic resonance imaging showing a round homogenously enhanced mass in the right frontal lobe with peritumoral edema. B : Positron emission tomography-computed tomography scan showing highly increased fludeoxyglucose uptake in the mass in the right frontal lobe.

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  Fig. 3 Histopathologic findings of brain specimen. (A) Large atypical lymphoid cells are arranged in a sheet-like growth pattern. Immunohistochemical labeling showing positive staining for leukocyte common antigen (B) and CD79a (C). The staining reactions for the pan-cytokeratin (D) and CD3 (E) are negative.

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