Gastric MALT lymphoma: old and new insights.
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 withHelicobacter pylori(H. pylori) infection. Only certainH. pyloristrains 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. pylorieradication 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 theAPI2-MALT1translocation, localization in the stomach, and patient ethnicity have been identified as predictors of remission. Recent data suggests thatH. pylorieradication therapy may be successful for gastric lymphoma treatment also in a small subgroup (15%) ofH. 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 followingH. pylorieradication include radiotherapy, chemotherapy and, in selected cases, surgery.
Gastroenterology and Digestive Endoscopy, 'Nuovo Regina Margherita' Hospital, Rome (Angelo Zullo, Cesare Hassan, Lorenzo Ridola).
Angelo
A
Zullo
Gastroenterology and Digestive Endoscopy, 'Nuovo Regina Margherita' Hospital, Rome (Angelo Zullo, Cesare Hassan, Lorenzo Ridola).
Cesare
C
Hassan
Gastroenterology and Digestive Endoscopy, 'Nuovo Regina Margherita' Hospital, Rome (Angelo Zullo, Cesare Hassan, Lorenzo Ridola).
Lorenzo
L
Ridola
Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Milan (Alessandro Repici).
Alessandro
A
Repici
Gastroenterology and Endoscopy Unit, New S. Agostino Hospital, Modena (Raffaele Manta).
Raffaele
R
Manta
Onco-Hematology Unit, 'Nuovo Regina Margherita' Hospital, Rome (Alessandro Andriani), Italy.
Alessandro
A
Andriani
Helicobacter pylori; MALT lymphoma; anti-tumor therapy; eradication therapy; gastric lymphoma