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Are lymphocytic monoclonality and immunoglobulin heavy chain (IgH) rearrangement premalignant conditions in chronic gastritis?

✍ Scribed by Thomas Wündisch; Christian Thiede; Birgit Alpen; Manfred Stolte; Andreas Neubauer


Book ID
102333532
Publisher
John Wiley and Sons
Year
2001
Tongue
English
Weight
60 KB
Volume
53
Category
Article
ISSN
1059-910X

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✦ Synopsis


Abstract

Normal gastric mucosa is devoid of lymphoid cells. Any increase of lymphocytes suggests chronic inflammation. Infection with Helicobacter pylori (Hp) is the major cause for nonautoimmune chronic gastritis and induces a mixed cellular response resulting in an acquired lymphoid tissue, or MALT (mucosa‐associated lymphoid tissue). Hp has also been implicated in the genesis of gastric MALT‐lymphoma. Polymerase chain reaction‐based assays to detect the expansion of monoclonal B‐cells have also been used to corroborate the diagnosis. In a considerable number of cases monoclonal B‐cells remain detectable in follow‐up biopsies, with the lymphoma being in complete histological remission. The clinical relevance of this finding is not clear yet. However, there also exist different reports that monoclonal B‐cells can be found in gastric biopsies of patients with neither a histological sign nor a present or past history of lymphoma. In the light of these findings we address the question whether B‐cell monoclonality can be seen as a premalignant condition in chronic gastritis and conclude that as of now the relevance of the finding of B‐cell monoclonality remains unclear. As of now the only and gold standard for the diagnosis of gastric MALT‐lymphoma is histopathology. Microsc. Res. Tech. 53:414–418, 2001. © 2001 Wiley‐Liss, Inc.


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