Gastric MALT lymphoma: old and new insights.

The stomach is the most frequent site of extranodal lymphoma. Gastric lymphoma originating from mucosa-associated lymphoid tissue (MALT) is typically a low-grade, B-cell neoplasia strongly associated with () infection. Only certain strains in some predisposed patients determine lymphoma development in the stomach, according to a strain-host-organ specific process. The clinical presentation is poorly specific, symptoms ranging from vague dyspepsia to alarm symptoms. Similarly, different endoscopy patterns have been described for gastric lymphoma. eradication is advised as first-line therapy in early stage disease, and complete lymphoma remission is achieved in 75% of cases. Neoplasia stage, depth of infiltration in the gastric wall, presence of the translocation, localization in the stomach, and patient ethnicity have been identified as predictors of remission. Recent data suggests that eradication therapy may be successful for gastric lymphoma treatment also in a small subgroup (15%) of -negative patients. The overall 5-year survival and disease-free survival rates are as high as 90% and 75%, respectively. Management of patients who failed to achieve lymphoma remission following eradication include radiotherapy, chemotherapy and, in selected cases, surgery.