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Helicobacter pylori infection in gastric extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma: a re-evaluation
  1. Larissa Sena Teixeira Mendes,
  2. Ayoma D Attygalle,
  3. Andrew C Wotherspoon
  1. Department of Histopathology, Royal Marsden Hospital, London, UK
  1. Correspondence to Dr Andrew C Wotherspoon, Department of Histopathology, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK; andrew.wotherspoon{at}

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In 1991 Wotherspoon et al 1 showed a close association between Helicobacter pylori infection and gastric mucosa-associated lymphoid tissue (MALT) lymphoma (GML) with the organism present in 92% of cases. Other studies have shown this association to be varying between 42% and 100%. In vitro studies at that time showed that lymphoma cell proliferation was associated with the presence of H. pylori mediated through specific tumour infiltrating T cells in a contact dependant manner. In the light of this finding Wotherspoon et al 1 were able to demonstrate that eradication of H. pylori induced lymphoma regression.

In a recent Gut article, Nakamura et al 2 demonstrated that H. pylori eradication therapy can result in durable lymphoma regression in the majority of cases. However, absence of H. pylori infection is a known predictive factor for eradication resistance.3

Prevalence of H. pylori has shown signs of decrease especially among Western populations. A decline in the number of GML H. pylori-positive has also been reported.4–7 To address these issues, we performed a retrospective review to analyse the H. pylori infection status …

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  • Contributors LSTM and ACW (study guarantor) performed the research, analysed the data and wrote the paper; ADA analysed the data and revised the manuscript critically. All authors had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity and accuracy of the data.

  • Competing interests All authors (LSTM, ADA and ACW) have completed the Unified Competing Interest form at and declare no financial support/sponsors for the submitted work; LSTM, ADA and ACW declare no relationships that might have an interest in the submitted work in the previous 3 years; spouses, partners or children have no financial relationships that may be relevant to the submitted work; and LSTM, ADA and ACW have no financial interests that may be relevant to the submitted work.

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  • Transparency declaration The lead author declares that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study have been explained.