MALT Lymphoma as a Model of Chronic Inflammation-Induced Gastric Tumor Development

  • Lukas Marcelis
  • Thomas Tousseyn
  • Xavier SagaertEmail author
Part of the Current Topics in Microbiology and Immunology book series (CT MICROBIOLOGY, volume 421)


Mucosa-associated lymphoid tissue (MALT) lymphoma, or extranodal marginal zone lymphoma of MALT, is an indolent B-cell non-Hodgkin lymphoma linked with preexisting chronic inflammation. The stomach is the most commonly affected organ and the MALT lymphoma pathogenesis is clearly associated with Helicobacter pylori gastroduodenitis. Inflammation induces the lymphoid infiltrates in extranodal sites, where the lymphoma then subsequently develops. Genetic aberrations arise through the release of reactive oxygen species (ROS), H. pylori-induced endonucleases, and other effects. The involvement of nuclear factor kappa B (NF-κB) pathway activation, a critical regulator of pro-inflammatory responses, further highlights the role of inflammation in gastric MALT lymphoma. The NF-κB pathway regulates key elements of normal lymphocyte function, including the transcription of proliferation-promoting and anti-apoptotic genes. Aberrant constitutive activation of NF-κB signaling can lead to autoimmunity and malignancy. NF-κB pathway activation can happen through both the canonical and non-canonical pathways and can be caused by multiple genetic aberrations such as t(11;18)(q12;q21), t(1;14)(p22;q32), and t(14;18)(q32;q21) translocations, chronic inflammation and even directly by H. pylori-associated mechanisms. Gastric MALT lymphoma is considered one of the best models of how inflammation initiates genetic events that lead to oncogenesis, determines tumor biology, dictates clinical behavior and leads to viable therapeutic targets. The purpose of this review is to present gastric MALT lymphoma as an outstanding example of the close pathogenetic link between chronic inflammation and tumor development and to describe how this information can be integrated into daily clinical practice.


Gastric MALT lymphoma Helicobacter pylori Chronic inflammation Lymphomagenesis NF-κB signaling 


Conflicts of Interest

The authors have no conflicts of interest to declare.

Financial Support

TT holds a Mandate for Fundamental and Translational Research from the “Stichting tegen Kanker” DNA dama2014-083).

LM is a Ph.D. student, financially supported by KULeuven, Department of Imaging and Pathology, “Stefanie’s Rozen fonds”, “Fonds Tom Debackere”, Stichting Me2You’ and “Emmanuel van der Schueren beurs (Kom op tegen Kanker)”.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Lukas Marcelis
    • 1
    • 3
  • Thomas Tousseyn
    • 1
    • 2
    • 3
  • Xavier Sagaert
    • 1
    • 2
    • 3
    Email author
  1. 1.Translational Cell and Tissue Research Lab, Department of Imaging and PathologyKU LeuvenLouvainBelgium
  2. 2.Department of PathologyUZ Leuven, University HospitalsLouvainBelgium
  3. 3.LouvainBelgium

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