MALT lymphoma

Last revised by Mohammad Taghi Niknejad on 23 Dec 2023

Mucosa-associated lymphoid tissue (MALT) lymphoma, sometimes shortened to MALToma, is a type of low-grade extranodal lymphoma.

In the 5th edition of the WHO classification of haematolymphoid tumors, it is a mature B-cell neoplasm termed extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue. This is a separate entity from "nodal marginal zone lymphoma", found in the marginal zone of the germinal follicles of a lymph node.

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:

Metastases to other sites including lymph nodes and bone marrow are not uncommon. 

Imaging features of MALT lymphoma depend on which organ is affected. 

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 their use in treating non-gastric MALT lymphoma 7.

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