Primary gastric lymphoma of MALT: considerations of pathogenesis, diagnosis and therapy

Primary gastric lymphoma of mucosa-associated lymphoid tissue (MALT) is a distinct entity with its own histological classification. Epidemiological, histomorphological, molecular biological and experimental data clearly underline that infection of the gastric mucosa by Helicobacter pylori plays an important role in both the development and progression of MALT lymphoma. Considering the histological grade of malignancy and dissemination (stage) of the disease as decisive prognostic factors, and therapeutic determinants, endoscopic bioptical diagnosis and endoscopic ultrasound are of particular importance. In cases of localized (stage 1), low grade lymphoma, eradication of H pylori offers a promising and fascinating therapeutic option. Surgical resection, radiotherapy or chemotherapy, and their combination, have proven to be effective treatment modalities. There is a need to clarify whether operative or conservative therapeutic strategies should be favoured in the future.