MALT lymphoma pathophysiology: Difference between revisions
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==Gross Pathology== | ==Gross Pathology== | ||
MALT lymphoma starts in the tissues or organs outside of the lymph nodes (''extranodal''). MALT lymphoma develops in mucosa-associated lymphoid tissue, in the mucosa, or tissue that lines body organs or body cavities including:<ref name=extranodalmarginalzoneofmucosaassociatedlymphoidtissueMALTlymphoma1>Extranodal marginal zone of mucosa-associated lymphoid tissue (MALT lymphoma). Canadian Cancer Society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/malt-lymphoma/?region=on. Accessed on January 28, 2016</ref> | MALT lymphoma starts in the tissues or organs outside of the lymph nodes (''extranodal''). MALT lymphoma develops in mucosa-associated lymphoid tissue, in the mucosa, or tissue that lines body organs or body cavities including:<ref name=extranodalmarginalzoneofmucosaassociatedlymphoidtissueMALTlymphoma1>Extranodal marginal zone of mucosa-associated lymphoid tissue (MALT lymphoma). Canadian Cancer Society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/malt-lymphoma/?region=on. Accessed on January 28, 2016</ref><ref name="KinkadeEsan2015">{{cite journal|last1=Kinkade|first1=Zoe|last2=Esan|first2=Olukemi A.|last3=Rosado|first3=Flavia G.|last4=Craig|first4=Michael|last5=Vos|first5=Jeffrey A.|title=Ileal mucosa-associated lymphoid tissue lymphoma presenting with small bowel obstruction: a case report|journal=Diagnostic Pathology|volume=10|issue=1|year=2015|issn=1746-1596|doi=10.1186/s13000-015-0353-6}}</ref> | ||
*[[Gastrointestinal tract]] | *[[Gastrointestinal tract]] (30-40%) | ||
**The stomach is the most common location for MALT lymphoma, but they can also occur in the small bowel and colon. | **The stomach is the most common location for MALT lymphoma, but they can also occur in the small bowel and colon. | ||
*[[Lungs]] | *[[Lungs]] |
Revision as of 18:44, 28 January 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
MALT lymphoma (MALToma) is a form of lymphoma involving the mucosa-associated lymphoid tissue (MALT), frequently of the stomach, but virtually any mucosal site can be afflicted. It is a cancer originating from B cells in the marginal zone of the MALT
Pathogenesis
MALT lymphoma (MALToma) is a form of lymphoma involving the mucosa-associated lymphoid tissue (MALT), frequently of the stomach, but virtually any mucosal site can be afflicted. It is a cancer originating from B cells in the marginal zone of the MALT
Genetics
- Development of [MALT lymphoma is the result of multiple genetic mutations.
- Genes involved in the pathogenesis of MALT lymphoma are tabulated below:[1]
Associated Conditions
- Gastric MALT lymphoma is frequently associated with chronic inflammation as a result of the presence of Helicobacter pylori (72-98%).[2]
- Chronic immune stimulation is also suspected in the pathogenesis of non-gastric MALT lymphoma, and hence often have a history of autoimmune disorders such as:
Gross Pathology
MALT lymphoma starts in the tissues or organs outside of the lymph nodes (extranodal). MALT lymphoma develops in mucosa-associated lymphoid tissue, in the mucosa, or tissue that lines body organs or body cavities including:[3][4]
- Gastrointestinal tract (30-40%)
- The stomach is the most common location for MALT lymphoma, but they can also occur in the small bowel and colon.
- Lungs
- Eyes, including the orbit
- Skin
- Salivary glands
- Thyroid gland
- Breasts
MALT lymphoma pathophysiology | |
Endoscopic image of gastric MALT lymphoma taken in body of stomach in patient who presented with upper GI hemorrhage. Appearance is similar to gastric ulcer with adherent clot. |
Microscopic pathology
- On microscopic histopathological analysis, MALT lymphoma is characterized by expansion of the marginal zone compartment with development of sheets of neoplastic diffuse lymphoid cells consisting of small atypical cells with monocytoid features.[5]
- A characteristic feature of MALT lymphoma is the presence of neoplastic cells within epithelial structures with associated destruction of the glandular architecture to form lymphoepithelial lesions.[6]
- The morphology of the neoplastic cells is variable with small mature lymphocytes, cells resembling centrocytes (centrocyte-like cells), or marginal zone/monocytoid B cells.
- Plasmacytoid or plasmacytic differentiation is frequent.
- Lymphoid follicles are ubiquitous to MALT lymphoma but may be indistinct as they are often overrun or colonized by the neoplastic cells. Large transformed B cells are present scattered among the small cell population. If these large cells are present in clusters or sheets, a diagnosis of associated large B-cell lymphoma should be considered.
Immunohistochemistry
The noplastic cells of MALT lymphoma may be positive for CD20 that co-express BCL-2 and are negative for CD5, CD10, CD43, and cyclin D1.[4]
References
- ↑ Troppan, Katharina; Wenzl, Kerstin; Neumeister, Peter; Deutsch, Alexander (2015). "Molecular Pathogenesis of MALT Lymphoma". Gastroenterology Research and Practice. 2015: 1–10. doi:10.1155/2015/102656. ISSN 1687-6121.
- ↑ Parsonnet J, Hansen S, Rodriguez L, Gelb A, Warnke R, Jellum E, Orentreich N, Vogelman J, Friedman G (1994). "Helicobacter pylori infection and gastric lymphoma". N Engl J Med. 330 (18): 1267–71. PMID 8145781.
- ↑ Extranodal marginal zone of mucosa-associated lymphoid tissue (MALT lymphoma). Canadian Cancer Society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/malt-lymphoma/?region=on. Accessed on January 28, 2016
- ↑ 4.0 4.1 Kinkade, Zoe; Esan, Olukemi A.; Rosado, Flavia G.; Craig, Michael; Vos, Jeffrey A. (2015). "Ileal mucosa-associated lymphoid tissue lymphoma presenting with small bowel obstruction: a case report". Diagnostic Pathology. 10 (1). doi:10.1186/s13000-015-0353-6. ISSN 1746-1596.
- ↑ Taal, B G; Boot, H; van Heerde, P; de Jong, D; Hart, A A; Burgers, J M (1 October 1996). "Primary non-Hodgkin lymphoma of the stomach: endoscopic pattern and prognosis in low versus high grade malignancy in relation to the MALT concept". Gut. 39 (4): 556–561. doi:10.1136/gut.39.4.556.
- ↑ Janusz, edited by Jankowski, (2012). Handbook of Gastrointestinal Cancer (2 ed.). Chicester: John Wiley and Sons Ltd. pp. 243–244. ISBN 978-0-470-65624-2.