History: 55 yo female with upper abdominal pain.
Solution: The primary finding on the CT scan is a focal area of thickening and mass disease in the posterior aspect of the distal stomach. The primary differential would be a gastric adenocarcinoma and a gastric lymphoma. This turned out to be a Gastric MALT, which is a rare type of non-Hodgkin lymphoma and represents approximately 12-18 percent of the extranodal non-Hodgkin lymphoma. Lymphoid tissue is thought to be stimulated in response to colonization of the gastric lining by H. pylori and this rarely will lead to MALT lymphoma. In fact, nearly all patients with gastric MALT have H. pylori infection. Treatment of the H. pylori infection actually often controls the lymphoma. If this fails, then radiation is generally the next step followed less frequently by surgery and chemotherapy.