Gastric MALT lymphoma: Old and new insights

Angelo Zullo, Cesare Hassan, Lorenzo Ridola, Alessandro Repici, Raffaele Manta, Alessandro Andriani

Research output: Contribution to journalArticle

Abstract

The stomach is the most frequent site of extranodal lymphoma. Gastric lymphoma originating from mucosa-associated lymphoid tissue (MALT) is typically a low-grade, B-cell neoplasia strongly associated with Helicobacter pylori (H. pylori) infection. Only certain H. pylori strains in some predisposed patients determine lymphoma development in the stomach, according to a strain-host-organ specific process. The clinical presentation is poorly specific, symptoms ranging from vague dyspepsia to alarm symptoms. Similarly, different endoscopy patterns have been described for gastric lymphoma. H. pylori eradication is advised as first-line therapy in early stage disease, and complete lymphoma remission is achieved in 75% of cases. Neoplasia stage, depth of infiltration in the gastric wall, presence of the API2-MALT1 translocation, localization in the stomach, and patient ethnicity have been identified as predictors of remission. Recent data suggests that H. pylori eradication therapy may be successful for gastric lymphoma treatment also in a small subgroup (15%) of H. pylori-negative patients. The overall 5-year survival and disease-free survival rates are as high as 90% and 75%, respectively. Management of patients who failed to achieve lymphoma remission following H. pylori eradication include radiotherapy, chemotherapy and, in selected cases, surgery.

Original languageEnglish
Pages (from-to)27-33
Number of pages7
JournalAnnals of Gastroenterology
Volume27
Issue number1
Publication statusPublished - 2014

Keywords

  • Anti-tumor therapy
  • Eradication therapy
  • Gastric lymphoma
  • Helicobacter pylori
  • MALT lymphoma

ASJC Scopus subject areas

  • Gastroenterology

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  • Cite this

    Zullo, A., Hassan, C., Ridola, L., Repici, A., Manta, R., & Andriani, A. (2014). Gastric MALT lymphoma: Old and new insights. Annals of Gastroenterology, 27(1), 27-33.