Editor,—Taal et al showed recently (Gut 1996; 39: 556–61) that both clinical parameters and endoscopic findings differ significantly between low and high grade gastric mucosa associated lymphoid tissue (MALT) lymphoma . In fact, low grade MALT lymphoma has often been interpreted endoscopically as a benign condition, whereas high grade MALT lymphoma often has neoplastic-like features. Weight loss and older age are more frequent in high grade MALT lymphoma.

In our experience the endoscopic findings and clinical parameters differ from the data reported by Taal et al.

Between 1993 and 1996 we diagnosed one high grade and three low grade MALT lymphomas. In the low grade MALT lymphomas (one 70 year old man and two women, one 65 and the other 56 years old), the endoscopic findings were a gastric ulcer in the male patient, and a large antral mass with multiple ulcerations in the first and a large polypoid mass with pyloric obstruction in the second female patient. All of them had lost weight (6–10 kg). The male patient and the female patient with multiple antral ulcerations were Helicobacter pyloripositive. These patients were treated with an H pylorieradication regimen, and the H pylori negative patient was treated with polichemotherapy. In …