MALT lymphoma
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MALT lymphoma is a form of non-Hodgkin lymphoma (NHL) involving the mucosa-associated lymphoid tissue, frequently of the stomach, but virtually any mucosal site can be afflicted. It is a cancer originating from B cells in the marginal zone of the MALT.
Gastric MALT lymphoma is frequently associated (72-98%) with chronic inflammation as a result of the presence of Helicobacter pylori (Parsonnet et al, 1994). The initial diagnosis is made by biopsy of suspicious lesions on esophagogastroduodenoscopy (EGD, upper endoscopy). In other sites, chronic immune stimulation is also suspected in the pathogenesis (e.g. association between chronic autoimmune diseases such as Sjögren's syndrome and Hashimoto's thyroiditis, and MALT lymphoma of the salivary gland and the thyroid).
If the disease is limited to the stomach (which is assessed with computed tomography), then 70-80% of patients will be cured by treatment with antibiotic eradication of H. pylori (Bayerdorffer et al, 1995). In contrast, if the disease has spread or has been refractory on antibiotics, chemotherapy may need to be considered. A t(11;18)(q21;q21) chromosomal translocation, giving rise to a AP12-MLT fusion gene, is predictive of poor response to eradication therapy (Liu et al, 2001). Two other genetic alterations, t(1;14)(p22;q32) and t(14;18)(q32;q21), which deregulated BCL10 and MALT1-genes respectively, seem to convert on the same pathway as API2-MLT (i.e., that of NF-kB).
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- Bayerdorffer E, Neubauer A, Rudolph B, Thiede C, Lehn N, Eidt S, Stolte M. Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure of Helicobacter pylori infection. MALT Lymphoma Study Group. Lancet 1995;345:1591-4. PMID 7783535.
- Isaacson PG, Du MQ. MALT lymphoma: from morphology to molecules. Nat Rev Canc 2004;4:644-53. PMID 15286744.
- Liu H, Ruskon-Fourmestraux A, Lavergne-Slove A, Ye H, Molina T, Bouhnik Y, Hamoudi RA, Diss TC, Dogan A, Megraud F, Rambaud JC, Du MQ, Isaacson PG. Resistance of t(11;18) positive gastric mucosa-associated lymphoid tissue lymphoma to Helicobacter pylori eradication therapy. Lancet 2001;357:39-40. PMID 11197361.
- Parsonnet J, Hansen S, Rodriguez L, Gelb AB, Warnke RA, Jellum E, Orentreich N, Vogelman JH, Friedman GD. Helicobacter pylori infection and gastric lymphoma. N Engl J Med 1994;330:1267-71. PMID 8145781.
