[MALT lymphoma of the gastrointestinal tract: description of clinical cases and review of the literature]. / Linfomi MALT del tratto gastroenterico: descrizione di casi clinici e revisione della letteratura.

ABSTRACT

MALT-lymphomas are tumors of the mucosa associated lymphoid tissue, without primitive involvement of lympho nodes and spleen. They are located preferentially in the gastroenteric tract specially in the stomach (27%), but they may occur also in the respiratory and urinary tracts. There is a very well known link between MALT-omas and Hp infection, not only in the gastroenteric tract, but also in other sites. Moreover eradication of Helicobacter pylori can, in some cases, contribute to achieve the complete remission of the tumor. In this article the Authors report three cases of MALT-lymphomas two of the stomach and one of the jejunum-ileum. Diagnosis is based on instrumental tests according to the involved tract and endoscopy of the upper digestive tract associated with biopsies more specific in case of gastric involvement; yet bioptic samples show a more significative incidence of false negative due to the extramucosal site of tumor. In these cases, a correct diagnosis will be obtained only through histologic examination of the surgical specimen. Surgery obtains good results in early stages, playing also a central role in palliation in association with radio- and chemotherapy. In case of low-grade B MALT-lymphomas of the stomach and in IE stages, eradication of Helicobacter pylori can, in 70-90% of cases, reduce the extension of the lymphocytic infiltration.