Mucosa-Associated Lymphatic Tissue Lymphomas (MALT or MALToma)

MALT lymphoma tumor cells
image by Euthman

Mucosa-Associated Lymphatic Tissue (MALT) Lymphoma is a very rare type of Non-Hodgkin’s Lymphoma. MALT tissue is lymphatic tissue that is found in the stomach, lungs, thyroid, salivary glands, intestines, and eyes, so it is classified as "extranodal" (out of the nodes). MALToma typically results from a mutation of B-cells in this extranodal tissue. It is an indolent, or slow growing, cancer.

MALToma can arise in any organ with MALT tissue. Though the stomach is the affected organ in most cases (2 out of 3), the lungs, thyroid, and eyes can be involved also. This cancer is associated with several diseases and conditions, such as the bacteria Helicobacter pylori, Sjogren Syndrome, Celiac Disease, Crohn’s Disease, or Hashimoto Thyroiditis.

This rare cancer occurs in one out of twenty lymphoma patients, and is more common in patients over the age of 60. The disease affects more women than men. It is estimated that 3,700 cases of MALT lymphoma will be diagnosed in 2009.

Diagnosis and Staging

Most patients present with symptoms like indigestion, stomach pain, bleeding in the stomach, and weight loss. A loss of appetite and fatigue are also common symptoms.

Diagnosis is made via endoscopy, where a doctor passes a small tube into the stomach from the throat to view the organ. During the endoscopy, the doctor may take pictures of the stomach lining and biopsy damaged tissue for testing.

Chest x-rays, blood tests, CT scans, ultrasounds, and bone marrow biopsies may also be taken to determine the spread of the disease through the body.

Most MALTomas are diagnosed as stage IE, meaning that it is found early in stage one. In this case, the cancer hasn’t spread. The more advanced stages involve a spread to the lymph nodes, but this only occurs in 20% of MALT cases.

Treatments

For patients with MALToma that began in their stomach, the treatments usually involve a heavy dose of antibiotics. MALToma is usually caused by a bacteria called Helicobacter pylori, and intensive antibiotics can remove it from a patient’s system. Sometimes, the removal of the bacteria causes a remission of the disease and no further treatment is necessary. In extreme cases, surgery or radiation may be necessary as well.

For patients with MALToma in other organs, treatment is different. It can involve any of the following, depending on the stage of the disease:

• Watch and wait
• Chemotherapy (especially when the intestines or lungs are involved)
• Radiation
• Surgery
• Steroid therapy
• Radioimmunotherapy - Zevalin is being studied as a treatment for MALT lymphoma
• Patients who are looking for more advanced treatment or who have lymphoma that does not respond to standard treatment may want to consider a clinical study. Click here to find clinical trials in your area.

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• Non-Hodgkin's Lymphoma: Aggressive Lymphomas
• Non-Hodgkin's Lymphoma: Indolent Lymphomas
• Non-Hodgkin's Lymphoma: Treatment
• Non-Hodgkin's Lymphoma: Resources
• Bone Marrow and Stem Cell Transplants