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Pathology Research International
Volume 2011, Article ID 193149, 8 pages
http://dx.doi.org/10.4061/2011/193149
Review Article

Molecular Aspects of H. pylori-Related MALT Lymphoma

Department of Pathology, The University of Michigan, 1301 Catherine Rd., Room M5224 Medical Science I, Ann Arbor, MI 48109, USA

Received 12 November 2010; Accepted 27 December 2010

Academic Editor: Brian P. Rubin

Copyright © 2011 Scott R. Owens and Lauren B. Smith. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Helicobacter pylori-related extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue is a paradigm for malignancy arising in an inflammatory background. While the diagnosis of H. pylori gastritis is often straightforward, distinction between severe gastritis and early lymphoma can be difficult and requires careful assessment of clinical findings in addition to histological features and immunohistochemical results. A number of cytogenetic abnormalities have been discovered in H. pylori-related lymphomas and several have clinical importance, related to the responsiveness of lymphoma to H. pylori eradication therapy, but routine molecular studies are not widely utilized. While molecular methods may be used in equivocal cases, a trial of conservative therapy is warranted given the propensity for these lymphomas to regress with eradication of the organism. Once therapy is initiated, care must be taken to avoid a premature assignment of disease refractoriness because complete response can take several months to more than a year. Cases truly refractory to H. pylori eradication therapy may be treated with adjuvant chemoradiation with a high response rate.