Marginal zone lymphomas
- Lesion
Slow lymphomas that grow where chronic infection or autoimmunity keeps B cells stimulated; early gastric ones can vanish when H. pylori is cured.
What it is
Marginal zone lymphomas are indolent tumours of antigen-experienced B cells. The extranodal type (MALT lymphoma) arises in tissue with chronic immune stimulation: the stomach in H. pylori gastritis, salivary glands in Sjögren disease, the thyroid in Hashimoto thyroiditis. Splenic and nodal forms also exist. They show the step from a polyclonal, antigen-driven response to a monoclonal tumour that still depends on T-cell help, which explains why early gastric MALT lymphoma regresses after the bacterium is eradicated.
Structure
- Small to medium B cells with moderate pale cytoplasm (monocytoid) around reactive follicles.
- Lymphoepithelial lesions in gastric glands or salivary ducts.
- Frequent plasmacytic differentiation.
Step by step
- A chronic infection or autoimmune disease brings lymphoid tissue into a site that normally has little of it.
- Antigen-driven, T-cell-dependent B-cell proliferation persists for years.
- A B-cell clone acquires mutations and grows, still needing T-cell help from the antigen response.
- Removing the antigen (eradicating H. pylori) can make the clone regress at this stage.
- Translocations such as t(11;18) make NF-κB signalling autonomous; the tumour no longer needs the antigen.
Markers
- CD20
- CD5 negative
- CD10 negative
- cyclin D1 negative
- BCL10 nuclear in t(1;14)
Clinical notes
- Gastric MALT lymphoma presents with dyspepsia or bleeding and is often found at endoscopy for gastritis.
- The stomach is the commonest extranodal site of lymphoma, and H. pylori infection is very common in Colombia and Latin America.
Test yourself
Think of the answer, then tap the question to see it.
Why can early gastric MALT lymphoma regress with antibiotics?
Its growth still depends on T-cell help driven by H. pylori antigens; removing the bacterium removes the stimulus.
What is a lymphoepithelial lesion?
Invasion and destruction of glandular epithelium by clusters of neoplastic marginal zone B cells.
Which translocation predicts that a gastric MALT lymphoma will not respond to H. pylori eradication?
t(11;18), forming BIRC3::MALT1.
Elsewhere in DurgiPedia
- Mucosa-associated lymphoid tissue (tonsils, Peyer patches)
- Innate-like lymphocytes: ILCs, γδ T, NKT, MAIT, B-1 and marginal-zone B cells
Connections
Microorganisms2
Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.
Sources: Non-Hodgkin Lymphoma Treatment (PDQ®)–Patient Version (National Cancer Institute (NCI), 2026).
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Representative model, for educational purposes only.