Mucosa-associated lymphoid tissue (MALT) lymphoma is a type of non-Hodgkin lymphoma. MALT belongs to a group of non-Hodgkin lymphomas called marginal zone lymphomas (MZL). There are three types:
- extranodal marginal zone lymphoma, also called MALT lymphoma
- nodal marginal zone lymphoma (NMZL)
- splenic marginal zone lymphoma (SMZL).
Your doctor may talk to you about the other types of marginal zone lymphomas before it is clear which type you have.
MALT lymphoma develops in the lymphatic tissue that lines some organs in the body (mucosa).
The most common area for MALT lymphoma to develop is the stomach. But it may start in other parts of the body, including the:
- thyroid gland
- salivary gland
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The symptoms of mucosa-associated lymphoid tissue (MALT) lymphoma depend on where in the body it started. You may have no symptoms at all.
For example, MALT lymphoma that started in the stomach may cause symptoms such as:
- pain in the tummy (abdomen)
- loss of appetite
- feeling sick (nausea).
MALT lymphoma that started in the lung may cause symptoms such as:
- a persistent cough
Some people also have symptoms that doctors call B symptoms. These can include:
- drenching night sweats which require a change of nightwear and bed covers
- high temperatures (fevers) with no obvious cause
- unexplained weight loss.
Knowing if you have any B symptoms will help your doctor to stage the lymphoma and plan your treatment.
Mucosa-associated lymphoid tissue (MALT) lymphoma usually starts in areas of the body where there has been long-term inflammation. This may be because of an infection or autoimmune condition in that area.
Most MALT lymphomas that develop in the stomach can be linked to an infection bacteria called Helicobacter pylori (H. pylori). If H. pylori infection is not treated, it can cause long-term inflammation of the stomach lining. Over time, this may cause a MALT lymphoma to develop.
Bacterial infections in other parts of the body may also cause a MALT lymphoma to develop. These can include the skin, eyes and bowel.
Long-term infection with the hepatitis C virus (HCV) is also a risk factor for MALT lymphoma. But it is important to remember that most people with HCV will not develop lymphoma.
Most MALT lymphomas that develop in the thyroid gland, salivary glands and lungs can be linked to autoimmune conditions. These include Hashimoto’s thyroiditis and Sjögren’s syndrome. Autoimmune diseases develop when the immune system attacks healthy body tissue by mistake.
- In Hashimoto’s thyroiditis, the immune system attacks the thyroid gland, making it less active. This affects the level of hormones it produces.
- In Sjögren’s syndrome, the immune system attacks glands that make tears and saliva. This causes dry eyes and a dry mouth.
MALT lymphoma can affect people of all ages, but it is more common around the age of 70.
Like other cancers, MALT lymphoma is not infectious. It cannot be passed on to other people.
The most common test for diagnosing mucosa-associated lymphoid tissue (MALT) lymphoma is a biopsy. A doctor will take a sample of tissue from the affected area. The tissue will be sent to a laboratory for testing.
The type of biopsy you need will depend on where the lymphoma has developed.
If you might have MALT lymphoma in the stomach, you will usually have an endoscopy. During the endoscopy, the doctor or nurse may take biopsies from different areas of your stomach.
If you might have MALT lymphoma in your lungs, your doctor may do a bronchoscopy.
Your cancer doctor or specialist can explain more about biopsies.
You can read more about the tests you may have in our information about non-Hodgkin lymphoma.
Waiting for test results can be difficult. You may find it helpful to talk to your family, friends or specialist nurse.
Your test results will help your doctors find out how many areas of your body are affected by lymphoma and where these areas are. This is called staging.
In MALT lymphoma of the stomach, doctors also measure how far the lymphoma has spread from the lining of the stomach into the deeper layers of the stomach.
Most MALT lymphomas are diagnosed at an early stage.
Lymphomas are also often grouped as either low-grade or high-grade. Low-grade lymphomas are usually slow growing. High-grade lymphomas usually grow more quickly. MALT lymphoma is a low-grade lymphoma. Rarely, it can change (transform) to a high-grade lymphoma.
Knowing the stage and grade of the lymphoma helps your doctor plan the right treatment for you.
We have more information about the stages and grades of non-Hodgkin lymphoma.
A team of specialists will meet to discuss the best possible treatment for you. They are called a multidisciplinary team (MDT).
Your doctor, cancer specialist or nurse will explain the different treatments and their side effects to you. They will also talk to you about things to consider when making treatment decisions.
Treatment for mucosa-associated lymphoid tissue (MALT) lymphoma depends on:
- the stage of the lymphoma
- whether it is linked to an infection
- whether you have symptoms that are causing problems
- if you have had treatment before.
The most common treatments for MALT lymphoma are:
Watch and wait
MALT lymphoma usually develops slowly. Some people may not need treatment for months or years. During this time, they will have regular check-ups to monitor the lymphoma. This is called watch and wait.
If you have MALT lymphoma in the stomach, you will have tests to check for an infection caused by the bacteria called H. pylori. If you have this, you will have a treatment called triple therapy to get rid of the infection. This involves taking two types of antibiotics and a treatment to reduce the amount of acid made by the stomach.
Getting rid of H. pylori may clear all signs of the lymphoma. This is called remission. But this may take several months. At regular times after triple therapy, you will have a test, called an endoscopy. This test checks the lymphoma is shrinking and that you do not need further treatment.
Immunotherapy and chemotherapy
Radiotherapy uses high-energy rays to destroy cancer cells, while doing as little harm as possible to nearby healthy cells. It may be used to treat localised MALT lymphoma in parts of the body such as the eye, thyroid gland or stomach.
- is not caused by H. pylori
- has not got better with antibiotic treatment.
Radiotherapy may also be used to treat localised MALT lymphoma in other parts of the body.
You may have some treatments as part of a clinical trial.
You will have regular follow-up appointments after your treatment. You can talk to your doctor or nurse about any concerns you may have at these appointments. Your doctor will want to know how you are feeling, and to check you are recovering from any side effects of treatment.
Sometimes side effects may continue or develop months or years after treatment. These are called late effects. We have more information about long-term and late effects of treatment for lymphoma.
Sex life and fertility
Cancer and its treatment can sometimes affect your sex life. There ways to improve your sexual well-being and to manage any problems.
Treatment for lymphoma may affect your fertility. If you are worried about your fertility it is important to talk with your doctor before you start treatment. We have more information about:
Everyone has their own way of dealing with illness and the different emotions they experience. You may find it helpful to talk things over with family and friends or your doctor or nurse.
Macmillan is also here to support you. If you would like to talk, you can:
The organisations below also offer information and support:
Blood Cancer UK
Lymphoma Action gives emotional support, advice and information for people with Hodgkin lymphoma or non-Hodgkin lymphoma and those close to them. It has a national network of people with lymphoma, as well as local groups. Their website has a section called trialslink where you can see information about lymphoma clinical trials.
Below is a sample of the sources used in our MALT lymphoma (extranodal marginal zone lymphoma) information. If you would like more information about the sources we use, please contact us at email@example.com
Kiesewetter B and Raderer M. Antibiotic therapy in nongastrointestinal MALT lymphoma: a review of the literature. Blood. 2013. 122:8;1350-1357. Available from: www.ashpublications.org/blood/article/122/8/1350/32065/Antibiotic-therapy-in-nongastrointestinal-MALT
Zucca E, Copie-Bergman C, et al on behalf of the ESMO Guidelines Working Group. Gastric marginal zone lymphoma of MALT type: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2013. 24 (Supplement 6): vi144–vi148. Available from: www.annalsofoncology.org/article/S0923-7534(19)31563-7/pdf
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Anne Parker, Consultant Haematologist.
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