• Masahiro Ochi, Kazunari Tominaga, Hirotoshi Okazaki, Kazuki Yamamori, Tomoko Wada, Masatsugu Shiba, Eiji Sasaki, Toshio Watanabe, Yasuhiro Fujiwara, Nobuhide Oshitani, Kazuhide Higuchi, and Tetsuo Arakawa.
• Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan. ochi@msic.med.osaka-cu.ac.jp
• Scand. J. Gastroenterol. 2006 Mar 1; 41 (3): 365-9.

AbstractA 74-year-old woman was referred to our department because of epigastralgia. Endoscopic findings revealed yellowish bumpy mucosa from the bulbus to the second portion of the duodenum. The patient was admitted to our hospital for further examinations and treatment for this lesion. Endoscopic mucosal resection (EMR) was performed on part of the lesion to obtain the final diagnosis, and then mucosa-associated lymphoid tissue (MALT) lymphoma of the duodenum was diagnosed using this procedure. In this case, no evidence of Helicobacter pylori infection in the patient's stomach was detected by any of the diagnostic examinations used, such as the urea breath test, histological study, culture, and serological antibody. For this reason, the patient's duodenal MALT lymphoma was treated solely with long-term clarithromycin, which had an inhibitory action on lymphocyte activation. The lesion showed slight improved during the first 12 days of treatment, and complete regression was reached after 6 months of treatment. It is suggested that the long-term use of clarithromycin may be effective for diseases of the gastrointestinal tract associated with the lymphocyte proliferation.

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