Clinical Analysis of MALT Lymphoma in the Stomach

Paik, Kwang Yeol; Noh, Jae Hyung; Heo, Jin Seok; Sohn, Tae Sung; Choi, Seong Ho; Joh, Jae Won; Kim, Sung; Kim, Yong Il

Abstract

PURPOSE: The aim of our study was to analyze the clinical and histopathological characteristics of mucosa associated lymphoid tissue (MALT) lymphoma in the stomach.
METHODS
We retrospectively reviewed the medical records of 22 patients with pathologically proven MALT lymphoma from Jan. 1995 to Sep. 2000 in Samsung Medical Center. The factors analyzed were operative procedures, tumor stage and histopathological characteristics.
RESULTS
Of 3658 patients with gastric malignancy, 22 (0.6%) patients, 7 men and 15 women from 25 to 70 years (mean, 48.8 years), were found to have MALT lymphoma. Fourteen cases (64%) were located in the antrum, 4 (18%) in the body and 4 (18%) in the fundus or the high body. Nineteen patients were managed with total gastrectomy and splenectomy, and 3 with radical subtotal gastrectomy. Histopathologically, the tumor was limited to the mucosa in 3 patients (13.6%), to the submucosa in 13 (59.1%), and extended to the muscularis propria in 6 (27.3%). The lymph node involvement was seen in 12 patients (54.6%). There were no cases of splenic, hepatic or bone marrow involvement. H. pylori was identified in 11 patients (50%). During the mean follow-up period of 32.7 months, there were no reports of tumor recurrence or death.
CONCLUSION
MALT lymphoma rarely disseminates at the time of diagnosis and rarely involves the bone marrow. Lymph node involvement, however, was relatively high. Total gastrectomy is effective in the management of patients with high grade MALT lymphoma and adjuvant chemotherapy is effective in cases of metastasis.