{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:26:32Z","timestamp":1791559592552,"version":"4.3.4"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T00:00:00Z","timestamp":1691539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["T32-HL007974"],"award-info":[{"award-number":["T32-HL007974"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is historically associated with Helicobacter pylori (HP) infections in more than 80% of patients. However, the incidence of HP-negative MALT lymphoma has been increasing. The clinicopathologic features have not been well studied, and optimal management strategies remain unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The pathology database was searched for primary gastric MALT lymphomas diagnosed from 2000 to 2017. The clinical data and the slides were reviewed. The cases were divided for analysis into those with a background of chronic gastritis with HP, chronic gastritis without HP, and without either a background of chronic gastritis or HP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 70 gastric MALT lymphoma cases identified, 26 (37% of total) had chronic gastritis and were positive for HP histologically (n = 23) or were HP positive by additional laboratory testing (n = 3). The remaining 44 (63% of total) cases were HP negative by histology. Within the HP-negative cases, 5 (11% of HP-negative cases) showed histologic gastritis while 39 (89% of HP-negative cases) did not have sufficient evidence of gastritis through review of slides (n = 18) or based on available pathology reports (n = 21). The HP-negative cases without gastritis had higher propensities to show a mass lesion on endoscopy compared with HP-positive cases (37.5% vs 11.1%, P = .02) at the initial diagnosis. The immunophenotype and rate of positive B-cell gene rearrangement were not significantly different between the 2 groups. While all HP-positive patients received antibiotics for HP eradication, treatment in the HP-negative group varied among antibiotics, radiation, rituximab, or chemotherapy. Among HP-negative patients with available follow-up, 13 (39%) showed disease recurrence, similar to the recurrence rate in HP-positive patients; however, no individual from either group has died of the disease thus far.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The incidence of HP-negative MALT lymphoma is increasing, and in our practice, it is currently more common than HP-associated MALT lymphomas. The pathophysiology of HP-negative MALT lymphoma without chronic gastritis remains unclear. Follow-up data in our study suggest that the prognosis of these cases is excellent despite varied management modalities.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajcp\/aqad088","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T17:10:17Z","timestamp":1691601017000},"page":"612-619","source":"Crossref","is-referenced-by-count":13,"title":["<i>Helicobacter pylori<\/i>\u2013negative mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach: A clinicopathologic analysis"],"prefix":"10.1093","volume":"160","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5505-3474","authenticated-orcid":false,"given":"Sean X","family":"Gu","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Yale School of Medicine, Yale University , New Haven, CT , US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2372-3653","authenticated-orcid":false,"given":"Alexa J","family":"Siddon","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Yale School of Medicine, Yale University , New Haven, CT , US"},{"name":"Department of Pathology, Yale School of Medicine, Yale University , New Haven, CT , US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott F","family":"Huntington","sequence":"additional","affiliation":[{"name":"Section of Hematology, Department of Internal Medicine, Yale School of Medicine, Yale University , New Haven, CT , US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhanpat","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Pathology, Yale School of Medicine, Yale University , New Haven, CT , US"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,9]]},"reference":[{"key":"2023120112210296300_CIT0001","first-page":"2515","article-title":"Extranodal malignant lymphoma arising from mucosa-associated lymphoid tissue","volume-title":"Cancer.","author":"Isaacson","year":"1984"},{"key":"2023120112210296300_CIT0002","volume-title":"WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues","author":"Swerdlow","year":"2016"},{"key":"2023120112210296300_CIT0003","first-page":"1267","article-title":"Helicobacter pylori infection and gastric lymphoma","volume-title":"N Engl J Med.","author":"Parsonnet","year":"1994"},{"key":"2023120112210296300_CIT0004","first-page":"5740","article-title":"Translocation of Helicobacter pylori CagA into human B lymphocytes, the origin of mucosa-associated lymphoid tissue lymphoma","volume-title":"Cancer Res.","author":"Lin","year":"2010"},{"key":"2023120112210296300_CIT0005","first-page":"1175","article-title":"Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma","volume-title":"Lancet.","author":"Wotherspoon","year":"1991"},{"key":"2023120112210296300_CIT0006","first-page":"R49","article-title":"BCA-1 is highly expressed in Helicobacter pylori-induced mucosa-associated lymphoid tissue and gastric lymphoma","volume-title":"J Clin Invest.","author":"Mazzucchelli","year":"1999"},{"key":"2023120112210296300_CIT0007","first-page":"797","article-title":"The role of antigenic drive and tumor-infiltrating accessory cells in the pathogenesis of Helicobacter-induced mucosa-associated lymphoid tissue lymphoma","volume-title":"Am J Pathol.","author":"Mueller","year":"2005"},{"issue":"5","key":"2023120112210296300_CIT0008","first-page":"1583","article-title":"Low-grade B cell lymphomas of mucosa-associated lymphoid tissue (MALT-type) require CD40-mediated signaling and Th2-type cytokines for in vitro growth and differentiation","volume":"150","author":"Greiner","year":"1997","journal-title":"Am J Pathol."},{"key":"2023120112210296300_CIT0009","first-page":"6612","article-title":"Tumor-associated macrophages as major source of APRIL in gastric MALT lymphoma","volume-title":"Blood.","author":"Munari","year":"2011"},{"key":"2023120112210296300_CIT0010","first-page":"575","article-title":"Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradication of Helicobacter pylori","volume-title":"Lancet.","author":"Wotherspoon","year":"1993"},{"key":"2023120112210296300_CIT0011","first-page":"97","article-title":"Gastric MALT lymphoma: from aetiology to treatment","volume-title":"Lancet Oncol.","author":"Du","year":"2002"},{"key":"2023120112210296300_CIT0012","first-page":"1591","article-title":"Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure of Helicobacter pylori infection. 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