Gastric lymphoma

Overview

Histological image of gastric MALT lymphoma

Gastric lymphoma is a type of cancer that originates in the lymphatic system and primarily affects the stomach. It is a rare form of non-Hodgkin lymphoma and can be classified into different types based on the specific lymphoid tissue involved. The most common type of gastric lymphoma is MALT lymphoma, which stands for mucosa-associated lymphoid tissue lymphoma.

Types of Gastric Lymphoma

Gastric lymphomas are generally categorized into two main types:

MALT Lymphoma

MALT lymphoma is the most prevalent form of gastric lymphoma. It arises from the mucosa-associated lymphoid tissue in the stomach. This type of lymphoma is often associated with chronic Helicobacter pylori infection, which can lead to the development of lymphoid tissue in the gastric mucosa.

Diffuse Large B-Cell Lymphoma

Diffuse large B-cell lymphoma (DLBCL) is another type of gastric lymphoma. It is more aggressive than MALT lymphoma and can arise de novo or from the transformation of a pre-existing MALT lymphoma.

Pathophysiology

Gastric lymphoma develops when lymphocytes, a type of white blood cell, undergo malignant transformation. In the case of MALT lymphoma, chronic antigenic stimulation, often due to Helicobacter pylori infection, leads to the proliferation of lymphoid tissue in the gastric mucosa. Over time, genetic mutations can occur, resulting in the development of lymphoma.

Clinical Presentation

Patients with gastric lymphoma may present with nonspecific symptoms such as:

• Abdominal pain
• Nausea and vomiting
• Weight loss
• Anorexia
• Gastrointestinal bleeding

Diagnosis

The diagnosis of gastric lymphoma typically involves:

• Endoscopy with biopsy: This is the primary method for obtaining tissue samples for histological examination.
• Imaging studies: CT scan or MRI may be used to assess the extent of the disease.
• Histopathological examination: This is crucial for determining the type of lymphoma and its characteristics.

Treatment

The treatment of gastric lymphoma depends on the type and stage of the disease:

MALT Lymphoma

• Antibiotic therapy: For MALT lymphoma associated with Helicobacter pylori, eradication of the bacteria can lead to regression of the lymphoma.
• Radiation therapy: This may be used for localized disease.
• Chemotherapy: In cases where the disease is more advanced or unresponsive to antibiotics.

Diffuse Large B-Cell Lymphoma

• Chemotherapy: The standard treatment is often a combination of drugs known as R-CHOP.
• Radiation therapy: May be used in conjunction with chemotherapy.

Prognosis

The prognosis for gastric lymphoma varies depending on the type and stage of the disease. MALT lymphoma generally has a favorable prognosis, especially when associated with Helicobacter pylori and treated early. Diffuse large B-cell lymphoma has a more variable prognosis and often requires aggressive treatment.

Related Pages

• Lymphoma
• Helicobacter pylori
• Non-Hodgkin lymphoma
• MALT lymphoma