Clinical Analysis of MALT Lymphoma in the Stomach

위장의 점막 연관성 림프조직 림프종(MALT Lymphoma)의 임상적 고찰

Purpose: The aim of this study was to analyze the clinical and the histopathological characteristics of mucosa associated lymphoid tissue (MALT) lymphomas in the stomach. Materials and Methods: We retrospectively reviewed the medical records of 22 patients who had been treated at Samsung Medical Center from Jan. 1995 to Sep. 2000 and who had been pathologically proven to have a MALT lymphoma. The factors we analyzed were operative procedure, tumor stage, and histopathological characteristics. Results: Of 3658 patients with a gastric malignancy, 22 patients proved to have a MALT lymphoma ($0.6\%$). There were 7 men and 15 women whose ages ranged from 25 years to 70 years (mean, 48.8 years). Forteen cases were located in the antrum, 4 ($18\%$) in the body and 4 ($18\%$) in the fundus or the high body. Nineteen of these patients were managed with total gastrectomy and splenectomy and 3 with radical subtotal gastrectomy. Histopathologically the tumor was limited to the mucosa in 3 patients ($1.36\%$), to the submucosa in 13 ($59.1\%$) and extended to the muscularis propria in 6 ($27.3\%$). Lymph node involvement was seen in 12 patients ($54.6\%$). There was no splenic or hepatic involvement. Bone marrow involvement was not seen in any patients. H. pylori was identified in 11 patients (50$\%$). During the mean follow-up period of 32.7 months, there were no reports of tumor recurrence or death. Conclusion: MALT lymphomas rarely disseminate by the time of diagnosis and rarely involve the bone marrow. Lymph node involvement is relatively high and a total gastrectomy is effective in managing patients with a MALT lymphoma.