[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [White cells, lymph nodes, spleen and thymus](https://durgical.com/en/general-pathology/areas/hematolymphoid/) › Marginal zone lymphomas # 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. Updated Nov 12, 2026 ## Key points - Gastric MALT lymphoma is the classic example of a lymphoma caused by a bacterial infection (H. pylori). - Lymphoepithelial lesions: tumour cells invading and destroying glandular epithelium. - t(11;18) BIRC3::MALT1 and other translocations activate NF-κB and predict failure to respond to antibiotics. - Other settings: Sjögren disease (parotid), Hashimoto thyroiditis, hepatitis C (splenic form). - CD20 positive; CD5, CD10 and cyclin D1 negative. ## 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. ## Memory aid MALT: chronic antigen, lymphoepithelial lesion, and a lymphoma that can be treated with antibiotics. ## 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. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/general-pathology/marginal-zone-lymphomas/) [More Pathology questions →](https://durgical.com/en/practice/?f=pathology) ## Elsewhere in DurgiPedia - [Mucosa-associated lymphoid tissue (tonsils, Peyer patches)](https://durgical.com/en/immunology/mucosa-associated-lymphoid-tissue/) - [Innate-like lymphocytes: ILCs, γδ T, NKT, MAIT, B-1 and marginal-zone B cells](https://durgical.com/en/immunology/innate-like-lymphocytes-ilcs-t-nkt-mait-b-1-and-marginal-zone-b-cells/) ## Connections ## Related 5 - [Helicobacter pylori gastritis](https://durgical.com/en/general-pathology/helicobacter-pylori-gastritis/) - [Gastrointestinal lymphoma](https://durgical.com/en/general-pathology/gastrointestinal-lymphoma/) - [Sialadenitis and xerostomia](https://durgical.com/en/general-pathology/sialadenitis-and-xerostomia/) - [Hepatitis C: why it becomes chronic, and its extrahepatic disease](https://durgical.com/en/general-pathology/hepatitis-c-why-it-becomes-chronic-and-its-extrahepatic-disease/) - [Oncogenic viruses and H. pylori: the table to know](https://durgical.com/en/general-pathology/oncogenic-viruses-and-h-pylori-the-table-to-know/) ## Related conditions 5 - [Non-Hodgkin lymphoma](https://durgical.com/en/conditions/non-hodgkin-lymphoma/) - [Helicobacter pylori gastritis](https://durgical.com/en/conditions/helicobacter-pylori-gastritis/) - [Sjögren disease](https://durgical.com/en/conditions/sjogren-disease/) - [Hypothyroidism](https://durgical.com/en/conditions/hypothyroidism/) - [Viral hepatitis](https://durgical.com/en/conditions/viral-hepatitis/) ## Microorganisms 2 - [Helicobacter pylori](https://durgical.com/en/microbiology/helicobacter-pylori/) - [Hepatitis C virus](https://durgical.com/en/microbiology/hepatitis-c-virus/) [← All of general pathology](https://durgical.com/en/general-pathology/) 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](https://www.cancer.gov/types/lymphoma/patient/adult-nhl-treatment-pdq) (National Cancer Institute (NCI), 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/general-pathology/marginal-zone-lymphomas/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/marginal-zone-lymphomas/