MALT lymphoma

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MALT lymphoma
Classification and external resources
Endoscopic image of gastric MALT lymphoma taken in body of stomach in patient who presented with upper GI hemorrhage. Appearance is similar to gastric ulcer with adherent clot.
ICD-O: 9699/3
OMIM 604860
DiseasesDB 31339
MeSH D018442

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MALT lymphoma

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Overview

MALT lymphoma is a form of non-Hodgkin lymphoma (NHL) involving the mucosa-associated lymphoid tissue (MALT), 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.

Associations

Gastric MALT lymphoma is frequently associated (72-98%) with chronic inflammation as a result of the presence of Helicobacter pylori. [1]

The initial diagnosis is made by biopsy of suspicious lesions on esophagogastroduodenoscopy (EGD, upper endoscopy). Simultaeneously tests for H pylori are also done to detect the presence of this microbe.

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).

Treatment

If the disease is limited to the stomach (which is assessed with computed tomography), then 70-80% of patients will have a complete regression on treatment with antibiotic eradication of H. pylori. [1]

Others may be effectively controlled with the use of radiotherapy, or surgery. Both modalities may be curative in localized disease.

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. [1]

Two other genetic alterations, t(1;14)(p22;q32) and t(14;18)(q32;q21), which deregulate BCL10 and MALT1-genes respectively, and seem to turn-on the same pathway as API2-MLT (i.e., that of NF-kB).

References

de:MALT-Lymphom
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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .

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