Successful Endoscopic Submucosal Dissection for Primary Esophageal Mucosa-Associated Lymphoid Tissue Lymphoma.
Endoscopic submucosal dissection may provide a diagnostic and therapeutic option for primary esophageal MALT lymphoma, as demonstrated in a case where the patient remained in remission for 3 years.
Where it sits
this study against the rest of the igf-1 lr3 (long r3 igf-1) corpusSummary and findings
A 70-year-old woman with primary esophageal MALT lymphoma underwent endoscopic submucosal dissection (ESD) for diagnosis and treatment. Complete resection was achieved, and the patient has remained in complete remission for 3 years without additional therapy. No therapeutic claims are made regarding the efficacy of ESD beyond this case report.
Abstract
Primary esophageal extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is extremely rare, and its optimal management has not been established. We report a case of primary esophageal MALT lymphoma that was successfully treated by endoscopic submucosal dissection (ESD). A 70-year-old woman presented with an elevated lesion in the lower esophagus that was detected incidentally on computed tomography. Endoscopy and endoscopic ultrasonography revealed a subepithelial lesion confined to the submucosal layer without apparent invasion of the muscularis propria. Although an endoscopic biopsy suggested a low-grade lymphoma, a definitive diagnosis could not be established because of the limited tissue volume. Therefore, ESD was performed to obtain an adequate specimen for definitive diagnosis, and complete resection was achieved as a result. Histopathological and immunohistochemical examinations of the resected specimen confirmed primary esophageal MALT lymphoma. The patient has remained in complete remission for 3 years without additional therapy. This case suggests that ESD may be a diagnostic and therapeutic option for primary esophageal MALT lymphoma. <b>Trial Registration</b>: N/A.
Background
This paper addresses the management of primary esophageal extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), a rare condition with unclear optimal treatment strategies. Prior knowledge indicates that MALT lymphoma can be challenging to diagnose due to limited tissue availability from biopsies. This study is significant as it explores the potential of endoscopic submucosal dissection (ESD) as both a diagnostic and therapeutic approach in such cases.
Methods
The study describes a case of a 70-year-old woman presenting with an elevated lesion in the lower esophagus. ESD was performed to obtain a sufficient tissue sample for diagnosis after an initial biopsy suggested low-grade lymphoma. The method involved complete resection of the lesion, and no specific dose or duration is reported.
Results
The primary endpoint was the successful complete resection of the lesion via ESD. The histopathological examination confirmed the diagnosis of primary esophageal MALT lymphoma. The patient has remained in complete remission for 3 years post-procedure.
Interpretation
This case adds to the limited literature on the management of primary esophageal MALT lymphoma, suggesting that ESD may be an effective option for both diagnosis and treatment. However, the lack of a control group and reliance on a single case limits the ability to draw broader conclusions about the efficacy of ESD. The effect size, while significant in terms of complete resection and remission, must be interpreted cautiously due to the absence of comparative data.
Key findings
- Complete resection achieved after endoscopic submucosal dissection.
- Patient has remained in complete remission for 3 years without additional therapy.
Limitations
- Single case report with no control group.
- Initial biopsy did not provide a definitive diagnosis.
- Limited generalizability due to small sample size.