Helicobacter pylori and lymphoproliferative disorders.

Primary gastric lymphoma of mucosa associated lymphoid tissue represent a distinct entity which is documented by their own histological classification. Our knowledge about all aspects of these lymphoma has substantially increased during the last few years. Epidemiological, histomorphological, molecular-biological and experimental data clearly underline that Helicobacter pylori infection of the gastric mucosa without doubt plays an important role both in the development and progression of MALT lymphoma. Considering histological malignancy (low grade and high grade lymphoma) and dissemination of the disease (stage) as decisive prognostic factors and therapeutical determinants, endoscopic bioptic diagnosis as well as endoscopic ultrasound are of major importance in establishing diagnosis and clinical stage. In the case of localized low grade lymphoma, eradication of Helicobacter pylori offers a promising therapeutic option. Surgical resection and radiochemotherapy have proven to be effective treatment modalities. There is a need for randomised trials to establish whether operative or conservative therapeutic strategies have to be favoured in the future.