Abstract :
Background: Primary gastric lymphoma is one of the less common gastric malignancies as compared to adenocarcinoma. Numerous bacterial and viral infections are linked to their etiology. One of the most frequent associations is with Helicobacter pylori infection that predisposes to the development of gastric lymphoma.Case Presentation: Here we present a case of 48 years old Female with complains of nausea, vomiting, weight loss and epigastric pain since 2 months. Upper Gastrointestinal endoscopy showed ulcerative lesion involving pre pyloric region and lesser curvature. Patients have undergone surgery, and we received distal gastrectomy specimen in histopathology. The representative sections were given and stained with hematoxylin and eosin stain. Microscopy showed stomach walls infiltrated by small to medium sized atypical cells. Immunohistochemistry was positive for CD -45 and CD - 20 and negative for Synaptophysin and CK -7. The final diagnosis of Non – Hodgkin’s Lymphoma – diffuse large B cell type was given. The patient was managed by multidisciplinary approach including partial gastrectomy, Helicobacter pylori eradication therapy and chemotherapy regimen including cyclophosphamide, adriamycin, vincristine, prednisolone and rituximab. The patient was followed up for six months and has no relapse or any other symptoms related to lymphoma. Regular follow up was advised for next 5 years.Conclusion: Helicobacter pylori infection usually remains as an asymptomatic carrier state. This case is worth reporting as only in rare instances, it results in severe outcomes like lymphoma. It highlights the association of Helicobacter pylori with primary gastric lymphoma and helps in understanding the pathogenesis of the disease.
Keyword :
Stomach, Helicobacter pylori, Lymphoma, Non – Hodgkin’s lymphoma, Immunohistochemistry.