Clinicopathologic characteristics and treatment of marginal zone lymphoma of mucosa‐associated lymphoid tissue (MALT lymphoma)

Abstract

Extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) accounts for 7% to 8% of newly diagnosed lymphomas. Because of its association with infectious causes, such as Helicobacter pylori (HP) or Chlamydophila psittaci (CP), and autoimmune diseases, it has become the paradigm of an antigen-driven malignancy. MALT lymphoma usually displays an indolent course, and watch-and-wait strategies are justified initially in a certain percentage of patients. In patients with gastric MALT lymphoma or ocular adnexal MALT lymphoma, antibiotic therapy against HP or CP, respectively, is the first-line management of choice, resulting in lymphoma response rates from 75% to 80% after HP eradication and from 33% to 65% after antibiotic therapy for CP. In patients who have localized disease that is refractory to antibiotics, radiation is widely applied in various centers with excellent local control, whereas systemic therapies are increasingly being applied, at least in Europe, because of the potentially systemic nature of the disease. Therefore, the objective of this review is to briefly summarize the clinicopathologic characteristics of this distinct type of lymphoma along with current data on management strategies.

Primary Urinary Tract Lymphoma: Rare but Aggressive

“…Although the urinary tract does not have any organized lymphoid tissue, PUTL may originate from lymphoid cells attracted to the area from recurrent infections (4,5). This hypothesis is supported by regression of some lymphomas in other parenchymal organs after the use of antibiotics, particularly MALT-associated lymphomas (13). In addition, the observation that bladder lymphomas occur more frequently in women than men could support the above theory since women experience cystitis more frequently than men.…”

“…In addition, the observation that bladder lymphomas occur more frequently in women than men could support the above theory since women experience cystitis more frequently than men. Moreover, higher frequency of MALT-associated lymphoma, which is commonly associated with bacterial infections (13), was noted in the bladder. A previous study failed to demonstrate an association between kidney lymphoma and Epstein-Barr virus infection (14).…”

“…Patients with bladder lymphoma were mainly female whereas those with kidney lymphoma were mainly male. Moreover, a higher frequency of MALT-associated lymphoma was noted in the bladder, which according to the literature is most commonly associated with bacterial infections (13). Contrary to kidney lymphoma, the majority of the bladder lymphomas were diagnosed at stage I.…”

Whole body magnetic resonance in indolent lymphomas under watchful waiting: The time is now

“…Similar to FL, asymptomatic patients with splenic MZL are commonly monitored without any treatment since WW does not compromise survival [6]; nevertheless, patients should be treated if they are symptomatic or have bulky disease or cytopenia [7]. Some MALT lymphoma patients can be monitored with WW as well, without significantly modifying survival rates [8]. The WW strategy can also be pursued with good results in some ocular, adnexal, and pulmonary MALT lymphomas [9,10].…”

Clinical features and outcome of lymphoma patients with pre‐existing autoimmune diseases

“…Moreover, Helicobacter pylori eradication is now the standard of care for H. pylori-positive gastric marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma). 7 In addition to immunodeficiency and infection, autoimmune diseases are considered to be a risk factor for malignant lymphoma.…”