Gastric Extranodal Marginal Zone B-Cell Lymphoma of MALT

Abstract

Low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma occurs worldwide and is mostly found in gastric antrum and gastric body. Endoscopic features vary from shallow ulcer to simple color change of mucosa, nodularity, or mass. Low-grade gastric MALT lymphomas with such nonspecific endoscopic findings are often difficult to differentiate from benign diseases. Low-grade gastric MALT lymphoma is strongly associated with Helicobacter pylori (H. pylori). H. pylori infection rate has been reported to be as high as 90 % among patients with low-grade gastric MALT lymphoma. Therefore, diagnosis and treatment of H. pylori infection is the first step in the management of gastric MALT lymphoma independent of the stage of disease. H. pylori eradication has now become the treatment of choice for low-grade gastric MALT lymphoma, and the remission rate of stage I disease has reached almost 80 %. Although most remission occurs within 6–12 months after H. pylori eradication, it takes more to be completely healed for some cases. Therefore, the time point of diagnosing complete remission and choosing future treatment option when the eradication is not led to the tumor regression are not clearly established yet.