MALT Lymphoma – Mechanism, Causes, Symptoms, Diagnosis and Treatment
Lymphoma essentially means a cancer or presence of malignancy in the cells of the lymph nodes. A lymph node is a small oval organ belonging to the immune system in the body. They are placed throughout the body and are linked by connections or lymphatic vessels which carry the lymphatic cells. The lymphatic cells are essentially B, T and other immune cells. They are extremely important as far as the basic immunity and protection of the body is concerned.
The gastrointestinal tract has a protective lining all through its length. It contains numerous glands and gastric pits. These glands contain cells which secrete stomach acid, mucus and different enzymes required for digestion. It also protects the gastric tract from the corrosive action of the stomach acid which is basically hydrochloric acid. There are lymph nodes which are associated with the gastric mucosa.
is a cancer in the lymphatic cells in the Mucosa Associated Lymphoid Tissue (MALT). It, most often, refers to the stomach but could imply other organs too. In this article, we are going to focus on the said disease affecting the gastric tract.
It is also known as a non-Hodgkin lymphoma. The Hodgkin lymphoma also starts from the white blood cells or lymphocytes but the two are different because both involve a different type of lymphocyte. However, the non-Hodgkin lymphoma discussed here, is more prevalent than the Hodgkin one. In the United States, it ranks sixth in the list of cancers affecting males and fifth in the list of cancers affecting females.
This particular variety of non-Hodgkin lymphoma affecting the gastric mucosa accounts for about 10% of all non-Hodgkin lymphomas. In the United States, about 1.5 in 100,000 are affected by this condition.
Mechanism of MALT Lymphoma
These are solid cancerous masses growing from malignancy originating in the immune cells associated with the gastric tract. The digestive tract has associated lymphocytes in clusters known as Peyer’s patches. In response to an infection in the digestive tract or auto immune disease like Sjgren’s syndrome, the white blood cells B-lymphocytes accumulate and keep on growing to fight the imminent infection. In this situation, a malignant cell can start developing and growing or mutating abnormally. This occurrence leads to the formation of a cancerous mass or malignant tumor very often in the stomach. The continuing infection originating from an antigen keeps on stimulating the immune system and keeps on producing the lymphocytes abnormally. An infection from the bacteria Helicobacter Pylori acts as a perfect trigger. 90% of the times this bacteria H Pylori is associated with such stomach tumors. In fact, it is also a major cause of diseases like Peptic Ulcer disease, gastric cancer etc.
- It is primarily associated with chronic inflammation caused by the presence of a chronic infection by Helicobacter Pylori. A biopsy involving the extraction of a tissue sample from the tumor through an endoscopic procedure needs to be done. Analysis of the tissue sample and testing it for H. Pylori infection can help find the actual cause of the infection. In 72-98% of the cases of the disease affecting the stomach, the origin could be traced to an H.Pylori infection.
- It is also associated with the presence of chronic auto immune diseases like Sjogren’s syndrome and Hashimoto’s thyroiditis. It affects the tissues of the thyroid and the salivary glands.
- Other factors, environmental, dietary or heredity could also be involved.
There are no predefined and specific symptoms of the disease. The symptoms could be generalized in nature like that of random abdominal pain, ulcers, fatigue, indigestion, bloating, nausea and weight loss.
A Computed Topography scan can help determine the extent to which the disease has spread. Other tests like medical history, blood test, bone marrow biopsy also help in gauging the extent to which it has spread.
Treatment of MALT Lymphoma
- The stimulus, in this case, the antigen Helicobacter Pylori is treated with strong antibiotics. Low grade lesions which are localized respond well to this treatment. High grade ones which are growing faster require more specific and aggressive treatment.
- Radiotherapy, chemotherapy or surgery may be considered part of an aggressive treatment strategy.
The outlook or prognosis of the disease is good. The percentage of patients experiencing a remission of more than 5 years is greater than 90%.