GASTRIC MALT-LYMPOMA - WHERE ARE WE GOING - A RETROSPECTIVE AND PROSPECTIVE VIEW 10 YEARS AFTER INTRODUCTION OF THE MALT CONCEPT

Primary gastric lymphoma of MALI (mucosa associated lymphoid tissue) r epresent a distinct entity. Epidemiological, histomorphological and ex perimental data clearly indicate that Helicobacter pylori infection of the gastric mucosa plays an important role both in the development an d progression of MALT lymphoma. Histological malignancy flow grade/hig h grade) and stage have been recognized as the two decisive prognostic factors determining the therapeutic strategy. to minimize potential p roblems in endoscopic-biotic diagnosis, a rigorous technique (mapping) is mandatory. Endoscopic ultrasound is of major importance in the det ermination of the local tumor spread (depth of tumor infiltration, per igastric lymph nodes) and should be performed routinely within the cli nical staging procedure. In case of low grade lymphoma eradication of Helicobacter pylori offers a promising therapeutic option. Surgical re section and radiochemotherapy have proven to be effective treatment mo dalities. It has to be clarified by randomized studies. if operative o r conservative strategies have to be favored in the future. An Europea n study dealing with this question started in 1998.