Case Report

Gastric MALT Lymphoma in the Absence of Helicobacter pylori Infection Presenting as an Upper Gastrointestinal Hemorrhage

Authors: Lt. Dustin Roberts, MD CDR, Michael Hopkins, MD LCDR, Steven Miller, MD CDR, T W. Schafer, MD

Abstract

Gastric MALT lymphoma is almost exclusively a sequelae of Helicobacter pylori infection and rarely presents with profuse bleeding. Gastric mucosa is not normally thought to contain lymphoid tissue, yet in the presence of H pylori reactive lymphoid follicles form which are possibly throught to predispose the patient to developing lymphoma. GI bleeding from these tumors is common during treatment as a consequence of tumor regression or necrosis. We present the case of a MALT Lymphoma in a 59 year-old woman manifesting as a brisk upper GI bleed without serologic or microbiologic evidence of an H pylori infection.


Key Points


* Gastric MALT lymphoma can arise in the absence of Helicobacter pylori infection, although this is rare.


* Gastric malignancies can present with massive upper GI hemorrhage, although this is also rare.


* Gastric MALT lymphoma responds well to monotherapy with external beam radiation.

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