Gastroenterology: gastric MALT lymphoma: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Gastroenterology: gastric MALT lymphoma

Sample item

A 58-year-old man with dyspepsia has gastric biopsies showing a low-grade marginal zone B-cell lymphoma with lymphoepithelial lesions, confined to the stomach wall, and Helicobacter pylori is detected. What is the most appropriate initial treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Helicobacter pylori eradication therapy

Low-grade gastric MALT lymphoma arises from chronic H. pylori-driven lymphoid stimulation. Eradication produces remission in a large majority of localised cases, which are followed endoscopically. Cases lacking response, often those with t(11;18) translocation, need radiotherapy or systemic therapy.

Option by option

  • A. CHOP chemotherapy

    Chemotherapy is reserved for advanced or refractory disease.

  • B. Helicobacter pylori eradication therapy (correct)

    Removing the antigenic stimulus with eradication therapy induces regression of localised H. pylori-positive MALT lymphoma.

  • C. Total gastrectomy

    Gastrectomy is unnecessarily morbid because eradication usually works.

  • D. Radiotherapy to the whole abdomen

    Abdominal radiotherapy is excessive and not first-line in early disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Helicobacter pylori eradication therapy. Low-grade gastric MALT lymphoma arises from chronic H.

Why is "CHOP chemotherapy" not the answer?

Chemotherapy is reserved for advanced or refractory disease.

Why is "Total gastrectomy" not the answer?

Gastrectomy is unnecessarily morbid because eradication usually works.

Why is "Radiotherapy to the whole abdomen" not the answer?

Abdominal radiotherapy is excessive and not first-line in early disease.

What concept does this question test?

It tests Gastroenterology: gastric MALT lymphoma in General Medicine. pylori-driven lymphoid stimulation. Eradication produces remission in a large majority of localised cases, which are followed endoscopically. Cases lacking response, often those with t(11;18) translocation, need radiotherapy or systemic therapy.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastroenterology: gastric MALT lymphoma?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.