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MALT lymphoma

Last updated: March 10, 2021

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Mucosa-Associated Lymphoid Tissue (MALT) lymphoma (also called MALToma or extranodal marginal zone lymphoma) is a B-cell non-Hodgkin lymphoma (NHL) that typically affects elderly patients in the 7th and 8th decades. MALTomas can be categorized according to their location as either gastric or nongastric. Gastric MALTomas are frequently associated with Helicobacter pylori (H. pylori) infection, whereas nongastric MALTomas are rather associated with autoimmune conditions (e.g., Sjögren syndrome, Hashimoto's thyroiditis). MALTomas typically present with nonspecific symptoms (e.g., fatigue, weight loss) and an unremarkable physical exam. Diagnosis is based on histopathology and immunohistochemistry. In the case of gastric MALTomas, a biopsy should be performed by upper gastrointestinal (UGI) endoscopy. Imaging techniques such as computed tomography (CT) are used for staging purposes. Treatment depends on the type of MALToma: Gastric MALTomas, for example, are treated in most cases with the eradication of the underlying H. pylori infection, whereas nongastric MALTomas are treated with radiation, chemotherapy, and surgery.

  • Approx. 5% of NHLs are due to MALTomas
  • Peak incidence: 7th and 8th decades

Epidemiological data refers to the US, unless otherwise specified.

MALTomas show an association with chronic immune stimulation (bacterial, autoimmune).

General approach

Gastric MALToma

  • Endoscopy: Additionally, upper gastrointestinal (UGI) endoscopy
  • Imaging: CT scan of the chest and abdomen with IV contrast for staging

Gastric MALTomas

Nongastric MALToma

  • Depends on the exact type and staging
  • Treatment options include : radiation, chemotherapy, surgery for local diseases
  1. Herold G. Internal Medicine. Herold G ; 2014