RESUMO
Primary hepatic lymphoma of mucosa-associated lymphoid tissue type is extremely rare. Only 38 cases have been reported to date. A case of a 59-year-old man with Helicobacter pylori-resistant gastric ulcers and Buerger disease who was followed up since 1999 is reported. A 2-cm hepatic nodule was incidentally found during partial gastrectomy and corresponded to mucosa-associated lymphoid tissue-type lymphoma without underlying liver disease. Molecular studies showed a clonal immunoglobulin heavy-chain gene rearrangement. Investigations for the mucosa-associated lymphoid tissue lymphoma-associated translocations t(11;18) and t(14;18), as well as the t(3;14)(q27;q32), were negative, whereas trisomy 3 and trisomy 18 were detected.
Assuntos
Cromossomos Humanos Par 18/genética , Cromossomos Humanos Par 3/genética , Neoplasias Hepáticas/patologia , Linfoma de Zona Marginal Tipo Células B/patologia , Trissomia , Intervalo Livre de Doença , Rearranjo Gênico de Cadeia Pesada de Linfócito B/genética , Humanos , Hibridização in Situ Fluorescente , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/imunologia , Neoplasias Hepáticas/cirurgia , Linfoma de Zona Marginal Tipo Células B/genética , Linfoma de Zona Marginal Tipo Células B/imunologia , Linfoma de Zona Marginal Tipo Células B/cirurgia , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVES: We previously showed that real-time PCR was a reliable technique for coupled detection of Helicobacter pylori and clarithromycin resistance mutations directly from biopsies. After one year of use, we compared its performances to those of histology, which remains the most employed method for H. pylori detection from gastric biopsies. MATERIALS AND METHODS: 518 subjects underwent endoscopy during the year 2003 with biopsies taken for H. pylori detection by histology, PCR, and in case of discrepancy between the two techniques, by culture. RESULTS: The prevalence of infection, defined as positive PCR and histology, and in case of discrepancy as a positive culture, was 30% (163/518). The percentage of concordance between the two tests was 87.8% (455/518). The sensitivity, specificity, positive and negative predictive values of PCR were 98.2%, 97.5%, 94.7%, and 99.1%, respectively. The corresponding performances of histology were 87.7%, 91.3%, 82.2%, and 94.2%, respectively (p<0.001). The prevalence of clarithromycin resistance was 30%. CONCLUSIONS: PCR is more accurate in routine than histology and permits easy determination of clarithromycin resistance, which is useful in countries like France where the prevalence of resistance is high.