Question 15#
Which of the following options is the best management of a low-grade gastric lymphoma of the gastric antrum?
A. H. pylori eradicationB. Chemotherapy ± radiation therapy
C. Wedge resection
D. Antrectomy
Correct Answer is A
Comment:
Low-grade mucosa-associated lymphoid tissue (MALT) lymphoma, essentially a monoclonal proliferation of B cells, presumably arises from a background of chronic gastritis associated with H. pylori. These relatively innocuous tumors then undergo degeneration to high-grade lymphoma, which is the usual variety seen by the surgeon. Remarkably, when the H. pylori are eradicated and the gastritis improves, the lowgrade MALT lymphoma often disappears. Thus, low-grade MALT lymphoma is not a surgical lesion.
Algorithm for gastric lymphoma treatment:
MALT= mucosa-associated lymphoid tissue.