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Gastric MALT lymphoma — ESEGH MCQ

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ModerateGI CancerGastric MALT lymphomaESEGH

A 61-year-old man has early-stage gastric MALT lymphoma on biopsies from an antral ulcer. Staging CT is negative and endoscopic ultrasound suggests disease limited to the mucosa and submucosa. H. pylori testing is positive. What is the most appropriate management?

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Correct answer: C — Helicobacter pylori eradication therapy with response surveillance

Localised gastric MALT lymphoma associated with H. pylori often regresses after eradication therapy, followed by endoscopic surveillance. Gastrectomy is not first-line for limited disease. Systemic chemotherapy is reserved for selected refractory, disseminated or transformed disease. The pearl is that an infection-driven lymphoma can be treated initially by removing the antigenic stimulus.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/digestive-tract-conditions