A case of a patient with gastric lymphoma that affected the bone marrow with the appearance of myeloma is revealed

The term “MALT” is the acronym for “mucosa-associated lymphoid tissue.”

MALT is diagnosed after an upper gastrointestinal endoscopy performed for mild dyspeptic symptoms. Photo: Shutterstock.

MALT lymphoma is a type of lymphoma that can affect various organs of the human body, including the stomach (gastric MALT lymphoma).

Meanwhile, extranodal marginal zone lymphoma (ENMZL) is usually an indolent disease, a rare form of malignant non-Hodgkin’s lymphoma, which affects B cells and develops at the expense of cell-associated lymphoid tissue. mucous membranes, although it also occurs, more rarely, in the lymph nodes.

Precisely a clinical case registered in Puerto Rico showed a rare scenario of biclonal gammopathy that developed for about 20 years in a patient with MALT lymphoma.

The 82-year-old Hispanic patient with a long history of ENMZL of gastric origin responded to antibiotic treatment with the eradication of the bacteria

Helicobacter pylori, but the disease progressed over time with a biclonal gammopathy and bone marrow involvement with marked plasmacytic differentiation.

Biclonal gammopathies are characterized by clonal proliferation of plasma cells, or their B lymphoid progenitors, with production of two abnormal immunoglobulins (M proteins or paraproteins). Paraproteinemia, however, are diseases characterized by an imbalance of immunoglobulin-producing cells that accompanies MALT lymphoma and correlates strongly with bone marrow involvement, and this involvement leads to disease progression.

The case of this patient details that precisely her disease evolved gradually from a typical case of gastric MALT lymphoma with eventual plasmacytic differentiation, which suggests that patients with MALT in remission should be routinely followed up to detect a possible relapse and also detect possible transformation to a plasma cell neoplasm.

“Because of this, we suggest that patients with ENMZL be routinely evaluated for the presence of paraproteins,” reads the case publication.

MALT-type gastric lymphoma is an oncological pathology that must be taken into account when studying a patient with possible gastric neoplasm, since its clinical presentation is very similar to that of most gastric neoplasms and its treatment currently lies in the eradication of the H. pylori.

MALT is usually diagnosed after upper gastrointestinal endoscopy performed for mild dyspeptic symptoms. Endoscopic ultrasound is important to determine the infiltration of lymphoma in the gastric wall and the presence of lymph nodes.

Access the case here.

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