When an EGD (esophagogastroduodenoscopy)
biopsy shows pathology concerning for B-cell involvement,
it usually means the pathologist saw abnormal lymphoid cells in the tissue that may be related to a
B-cell lymphoma, which is a type of blood cancer that starts in B lymphocytes, a kind of white blood cell.
Here’s why this might happen:
1. Lymphoid Infiltrate in the GI Tract
-
The stomach and intestines have lymphoid tissue as part of the immune system.
-
Sometimes, B-cells grow abnormally in the lining of the GI tract, forming masses or ulcers.
-
If these cells look clonal (all the same) or atypical, it raises concern for lymphoma.
2. Most Common: MALT Lymphoma
-
A common type of B-cell lymphoma in the stomach is MALT (mucosa-associated lymphoid tissue) lymphoma.
-
Often associated with H. pylori infection.
-
Chronic infection stimulates B-cells to grow uncontrollably.
3. What Pathologists Look For
-
Immunohistochemistry (IHC) tests: show markers like CD20, which is on B-cells.
-
Light chain restriction: too many kappa or lambda chains suggest clonal B-cell growth.
-
Cell appearance: large, irregular B-cells may indicate high-grade lymphoma.
4. Why It Matters
-
B-cell involvement may mean the patient has a form of gastrointestinal lymphoma, needing further tests like CT scan, bone marrow biopsy, or PET scan.
-
Early detection is important because some types (like MALT) respond well to antibiotics or immunotherapy.
