Possible Relationship between Helicobacter pylori Infection and Cap Polyposis of the Colon

The definitive version is available at www.blackwell-synergy.com.ArticleHELICOBACTER. 9(6): 651-656 (2004)journal articl

Successful treatment of mucosa-associated lymphoid tissue lymphoma in a patient with gastric and rectal lesions with metachronous and ectopic development

A 75-year-old female, who had an abnormal stomach x-ray finding, was admitted to the hospital for further examination and therapy. Upper GI endoscopy showed reddish and swollen folds on the greater curvature of the gastric body and a biopsy was of this lesion revealed malignant lymphoma (small cell type or mucosa-associated lymphoid tissue (MALT) lymphoma suspected). The patient was infected with Helicobacter pylori (H. pylori), however, in response to the patient's wishes, a total gastrectomy, omentectomy and splenectomy were performed and the histological diagnosis was gastric MALT lymphoma. Two courses of CHOP therapy (cyclophosphamide (CPM) 750 mg/m2/day, day 1, adriamycin (ADM) 50 mg/m2/day, day 1, vincristine sulfate (VCR) 1.4 mg/m2/day, day 1, prednisolone 100 mg/body, day 1–5) were administered as adjuvant chemotherapy. A colonoscopic examination performed about 4.5 yr after the operation revealed rectal submucosal tumors and the biopsied specimens were diagnosed as malignant lymphoma. A transanal focal resection was performed and the histological diagnosis was metachronous and ectopic development of MALT lymphoma. The histological finding was similar to the gastric lesion. About 4 and 7 yr after the first development of rectal MALT lymphoma, MALT lymphomas developed repeatedly in the rectal lesion, however, these were resected repeatedly and no developmenthas occurred during the past two years. This report presents a very rare case of metachronous and ectopic MALT lymphoma development in the gastric and rectal lesions

Immunohistochemical testing for <it>Helicobacter Pylori</it> existence in neoplasms of the colon

<p>Abstract</p> <p>Background</p> <p><it>Helicobacter pylori</it> is a common pathogen, and its prevalence varies with socioeconomic conditions (10–80%). It has recently been recognized as a class I carcinogen in relation to gastric cancer. The aim of this study was to investigate the presence of <it>Helicobacter pylori</it> in neoplasms of the colon by immunohistochemical methods.</p> <p>Methods</p> <p>The polypectomy materials of 51 patients (19 male and 32 female) who had undergone colonoscopic polypectomy were retrieved for retrospective examination. The endoscopic size and colonic localization of the polyps were recorded. Hematoxylin and eosin stains were evaluated according to histological type and grade of dysplasia. Biopsy stains were immunohistochemically treated with <it>Helicobacter pylori</it> antibodies by the streptavidine-biotin immunoperoxidase technique. <it>Helicobacter pylori</it> staining in the gastric mucosa was used as the control for the immunohistochemical method. Specimens were classified according to the presence of <it>Helicobacter pylori</it> under an optical microscope, and <it>Helicobacter pylori</it> positive specimens were stratified according to the respective staining pattern.</p> <p>Results</p> <p>Mean age was 61.88 ± 10.62 (40–82) years. Polyp sizes were 1.45 ± 0.92 (1–4) cm; and 25.5% of polyps were localized in the right colon, 68.6% in the left colon and 5.9% in the transverse colon. Presence of <it>Helicobacter pylori</it> was not correlated with localization (p > 0.05) or size of the polyps (p > 0.05).</p> <p>Eleven (21.6%) of all specimens included in the study were <it>Helicobacter pylori</it> positive by immunohistochemical methods. Of the <it>Helicobacter pylori</it> positive specimens, the staining pattern was diffuse: Equivocal in 90.9%, nonspecific with a finely granular type concentrated on the luminal surface in 90.9%, dot-like granular in 54.5%, and spiral in 9.1%. Of the tubular polyps, 17.9% were <it>H. pylori</it> positive, and the staining pattern was equivocal in 100%, luminal in 85.7%, and dot-like granular in 57.1%. Of the villous polyps, 60% were <it>H. pylori</it> positive, and the staining pattern was inconclusive in 66.7%, luminal in 100%, dot-like granular in 33.3%, and spiral in 33.3%. Of the cancerous cases, 25% were <it>H. pylori</it> positive and showed an equivocal, luminal, and dot-like granular staining pattern. No significant correlation was determined between histologic types and prevalence of <it>H. pylori</it> (p > 0.05).</p> <p>Conclusion</p> <p>The presence of <it>H. pylori</it> in colon polyps did not yield any correlation with polyp size, colonic localization or histopathologic type. The higher rate of <it>H. pylori</it> positivity in villous polyps does not present a causal relationship. We were able to determine <it>H. pylori</it> existence in colon polyps by immunohistochemical methods, albeit with no statistical significance.</p