MALT Lymphomas.

2003

**Editors Note: While this study dates back to 2003, it is still worth the reading for the information contained.**

Malek SN, Hatfield AJ, Flinn IW.

Source

The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 1650 Orleans Street, CRB Room 388, Baltimore, MD 21231, USA.

Abstract

Mucosa-associated lymphoid tissue (MALT) lymphomas occur in a variety of organs, including the orbit, conjunctiva, salivary glands, skin, thyroid gland, lungs, stomach, and intestine. These tumors are often localized and of indolent clinical behavior. Diagnosis is made by pathologic evaluation of a tissue biopsy. Careful staging is mandatory and tailored to the initial presentation. Staging includes a history and physical, chemistries, computed tomography scan, and bone marrow biopsy. 

This information is supplemented with an ear, nose, and throat consultation, esophagogastro-duodenoscopy, colonoscopy, endoscopic ultrasound of the stomach, and cytogenetic/immunohistochemical analysis of the tumors. Treatment is tailored to organ involvement and stage at presentation. Eradication of Helicobacter pylori using a triple anti-H. pylori regimen approved by the US Food and Drug Administration is standard therapy for all H. pylori-positive gastric MALT lymphomas. Endoscopic ultrasound- and computed tomography-staged gastric MALT stage IE tumors will achieve a complete response with this approach in approximately 60% to 90% of patients (the more superficial the tumor, the better the response). Patients with tumors that are T4 node-positive Musshoff stage IIE1 and IIE2 or tumors with adverse cytogenetics should receive radiotherapy or surgery with or without radiotherapy. Tumors with a significant high-grade component or large cell tumors with a minor low-grade MALT component should receive CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)-based chemotherapy. Localized MALT lymphomas of the orbit, conjunctiva, salivary glands, and thyroid gland are treated successfully with radiotherapy. Surgery as first-line therapy for gastric MALT lymphomas was replaced by attempts at organ preservation. In the past, margin-free surgical excision or tumor debulking followed by radiation therapy and chemotherapy has been highly effective for gastric MALT lymphomas. 

Therefore, surgical excision of large cell or bulky tumors of the stomach, thyroid, lung, and salivary gland, followed by adjuvant radiotherapy or chemotherapy, may still be an important consideration in selected patients. Surgery still has a role for patients with relapsed or refractory low-grade disease and life-threatening hemorrhage. Disseminated MALT lymphomas are incurable and are treated primarily with chemotherapy according to symptoms.

PubMed

Anti-Helicobacter pylori therapy in primary MALT lymphoma of rectum.

Jul 2012

De Sanctis V, Marignani M, Angeletti S, Assisi D, Armosini V, Valeriani M, Minniti G, Cox MC, Ruco L, Enrici RM.

Abstract 

Primary rectal MALT lymphoma is a very rare entity among extranodal MALT lymphomas and its therapeutic management has not been standardized. Different approaches including surgery, chemotherapy and radiotherapy have been proposed in the last decades. There have been reports on complete responses after anti-Helicobacter pylori therapy, also in patients without serological or histological evidence of Helicobacter pylori infection. In our patient we obtained a complete response with anti-Helicobacter pylori therapy and a disease-free survival of 34 months. Endoscopic ultrasound was useful for diagnosis and follow-up. Although the mechanisms that determined this response remain a matter of debate, anti-Helicobacter pylori therapy can be considered as first-line therapy in stage IE, nonbulky primary rectal MALT lymphoma. Endoscopic ultrasound could play a relevant role in the management of this rare condition

Journal of Experimental and Clinical Oncology

Systemic lupus erythematosus in a patient with primary MALT lymphoma of the larynx.

Systemic lupus erythematosus in a patient with primary MALT lymphoma of the larynx.
Ear Nose Throat J. 2009 Aug

Gonzàlez N, Xicoy B, Olivé A, Jové J, Ribera JM, Feliu E.
Clinical Hematology Department, Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona, Spain.

Primary lymphomas of the larynx are extremely rare. Even more unusual is their association with rheumatologic diseases. Some cases of lymphoma have developed after chemotherapy for rheumatologic diseases, suggesting that the treatment may contribute to the development of lymphoma. The converse can also occur-the development of rheumatologic disease after a primary laryngeal lymphoma-but that is even rarer. We report a case of primary extranodal marginal zone B-cell MALT (mucosa-associated lymphoid tissue)lymphoma of the larynx in a 42-year-old woman treated with involved-field radiotherapy who developed systemic lupus erythematosus (SLE) 1 year after the lymphoma diagnosis. Currently, the patient remains in remission 8 years after her diagnosis. The SLE, for which she is receiving maintenance therapy, is stable.

PMID: 19688705 [PubMed - in process]