Citation, DOI & article data
Mucosa-associated lymphoid tissue (MALT) lymphoma, also called extranodal marginal zone B-cell lymphoma or shortened to MALToma, is a type of low-grade extranodal lymphoma.
MALT lymphoma represents ~7.5% of non-Hodgkin lymphomas. The average age of presentation is 60 years with a slight female predominance 1. Prevalence is estimated at 2 per 100,000 7.
Clinical presentation depends on the affected organ. B-type symptoms are rare 1,3.
MALT lymphomas arise in epithelial tissues where lymphoid cells are not usually found. Chronic infection/inflammation has been implicated in the pathogenesis, for example, Helicobacter pylori infection with gastric MALT lymphoma, and Sjögren syndrome with salivary gland MALT lymphoma 1,3. Less than 10% transform from low-grade to high-grade disease 4.
MALT lymphoma can localize throughout the entire body 1,4:
- stomach: most common; 33-50% (see: gastric lymphoma)
- associated with H. pylori infection in 90% of cases 7
- intestine: ~5%
- possible association with celiac disease 6
- salivary glands: associated with Sjögren syndrome
- thyroid: associated with Hashimoto thyroiditis 5
- orbit (see: orbital lymphoma)
- lung and upper airways (see: BALT lymphoma)
Metastases to other sites including lymph nodes and bone marrow are not uncommon.
Imaging features of MALT lymphoma depend on which organ is affected.
Treatment and prognosis
MALT lymphoma is considered an indolent disease with a good prognosis. Treatment should be tailored to the affected organ and may consist of surgery, chemotherapy, and/or radiation therapy 2. Antibiotics are used to treat gastric MALT lymphoma; there is a lack of evidence for its use in treating non-gastric MALT lymphoma 7.
- 1. Robert Marcus, John W. Sweetenham, Michael E. Williams. Lymphoma. (2013) ISBN: 9781107010598 - Google Books
- 2. Michael L. Grossbard, American Cancer Society. Malignant Lymphomas. (2002) ISBN: 9781550091526 - Google Books
- 3. Reinhold Munker, Erhard Hiller, Jonathan Glass et al. Modern Hematology. (2007) ISBN: 9781588295576 - Google Books
- 4. Ali Guermazi, Ibrahim Fikry Abdelwahab. Radiological Imaging in Hematological Malignancies. (2004) ISBN: 9783540439998 - Google Books
- 5. Troch M, Woehrer S, Streubel B et al. Chronic Autoimmune Thyroiditis (Hashimoto's Thyroiditis) in Patients with MALT Lymphoma. Ann Oncol. 2008;19(7):1336-9. doi:10.1093/annonc/mdn049 - Pubmed
- 6. Smedby K, Akerman M, Hildebrand H, Glimelius B, Ekbom A, Askling J. Malignant Lymphomas in Coeliac Disease: Evidence of Increased Risks for Lymphoma Types Other Than Enteropathy-Type T Cell Lymphoma. Gut. 2005;54(1):54-9. doi:10.1136/gut.2003.032094 - Pubmed
- 7. Kiesewetter B & Raderer M. Antibiotic Therapy in Nongastrointestinal MALT Lymphoma: A Review of the Literature. Blood. 2013;122(8):1350-7. doi:10.1182/blood-2013-02-486522 - Pubmed