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MALT lymphoma

Last reviewed: 18 Aug 2025
Last updated: 10 Jan 2025

Summary

Definition

病史和体格检查

关键诊断因素

  • history of Helicobacter pylori gastritis
  • history of autoimmune disorder
  • age >60 years
  • dyspepsia
  • epigastric discomfort
  • skin lesions
  • red eye ± photophobia
  • conjunctival fornix mass
  • painless proptosis, motility disturbances of the eye, diplopia, ptosis, decreased vision
完整详情

其他诊断因素

  • abdominal pain, nausea, diarrhea, malabsorption, vomiting
  • GI bleeding, perforation, and obstruction
  • fever
  • night sweats
  • weight loss
  • shortness of breath, hemoptysis, cough
  • salivary gland swelling
  • thyroid swelling
  • esophageal/tracheal obstruction (shortness of breath, dysphagia, tracheal deviation)
  • breast lump
  • focal neurologic deficits
  • lymphadenopathy
完整详情

危险因素

  • Helicobacter pylori infection
  • age >60 years
  • autoimmune disease
  • Chlamydia psittaci infection
  • Campylobacter jejuni infection
  • Borrelia burgdorferi infection
  • hepatitis C virus infection
  • hepatitis B virus infection
  • HIV infection
  • achromobacter xylosoxidans infection
完整详情

诊断性检查

首要检查

  • CBC with differential
  • blood smear
  • comprehensive metabolic panel (including LFTs)
  • serum lactate dehydrogenase (LDH)
  • serum beta-2 microglobulin
  • upper GI endoscopy
  • biopsy of affected site
  • immunophenotyping
  • H pylori (histologic testing)
  • CT scan
完整详情

需考虑的检查

  • H pylori (stool antigen test)
  • H pylori (urea breath test)
  • H pylori (serology test)
  • PCR testing for infectious agents
  • bone marrow biopsy with aspirate
  • genetic studies
  • immunoglobulin gene rearrangement studies
  • MYD88 mutation testing
  • serum protein electrophoresis
  • 18F-fluorodeoxyglucose (FDG) PET/CT scan
  • endoscopic ultrasound of the stomach
  • lower GI endoscopy
  • MRI orbit, brain
  • mammography
  • breast ultrasound
  • MRI breast
  • thyroid ultrasound
  • bronchoscopy
  • hepatitis C serology
  • hepatitis B serology
  • HIV serology
  • multigated acquisition (MUGA) scan
  • echocardiography
完整详情

治疗流程

急症处理

localized gastric MALT lymphoma: Helicobacter pylori-positive and t(11;18)-negative (or unknown)

localized gastric MALT lymphoma: Helicobacter pylori-negative, or Helicobacter pylori-positive and t(11;18)-positive

advanced gastric MALT lymphoma

localized nongastric MALT lymphoma

advanced nongastric MALT lymphoma

high-grade histologic transformation

撰稿人

作者

Christopher McNamara, MBBS (Hons), FRACP, FRCPA, FRCPath

Consultant Haematologist

Royal Free Hospital

London

UK

利益声明

CM declares that he has no competing interests.

Acknowledgements

Dr Christopher McNamara wishes to gratefully acknowledge Dr Rahul Joshi, a previous contributor to this topic. RJ declared that he had no competing interests. Unfortunately, we have since been made aware that Dr Rahul Joshi is deceased.

Peer reviewers

Markus Raderer, MD

Professor of Medicine

Department of Internal Medicine I

Division of Oncology

Medical University Vienna

Austria

Disclosures

MR is an author of a number of references cited in this topic.

Alan Lichtin, MD

Staff Hematologist

Cleveland Clinic Taussig Cancer Center

Cleveland

OH

Disclosures

AL declares that he has no competing interests.

Ian Chau, MD

Consultant Medical Oncologist

Royal Marsden Hospital

Sutton

UK

Disclosures

IC has been reimbursed by Roche Products, the manufacturer of rituximab, for attending several conferences. IC has also served on advisory boards and received honorarium for giving presentations for Roche Products. IC has received research funding from Novartis to conduct academic studies in the treatment of colorectal cancer.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Zucca E, Arcaini L, Buske C, et al. Marginal zone lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020 Jan;31(1):17-29.Full text  Abstract

Walewska R, Eyre TA, Barrington S, et al. Guideline for the diagnosis and management of marginal zone lymphomas: a British Society of Haematology guideline. Br J Haematol. 2024 Jan;204(1):86-107.Full text  Abstract

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: B-cell lymphomas [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • MALT lymphoma images
  • Differentials

    • Mantle cell lymphoma
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  • Guidelines

    • NCCN clinical practice guidelines in oncology: B-cell lymphomas
    • Guideline for the diagnosis and management of marginal zone lymphomas
    More Guidelines
  • Patient information

    Non-Hodgkin lymphoma

    More Patient information
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