CXCR-4 -directed PET/CT examination in a case of marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma)

Background

Mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) is an indolent B-cell non-Hodgkin lymphoma originating from post-germinal center marginal zone B cells. It typically arises in mucosal sites due to chronic antigenic stimulation from autoimmune disorders or persistent infections (e.g., Helicobacter pylori in gastric MALT lymphoma) [1]. It accounts for 5–8% of all B-cell lymphomas, and is the most common extra-nodal marginal zone lymphoma, with an annual incidence of 1–2 cases per 100000 [2]. Common sites include the stomach, salivary glands, ocular adnexa, lung (where it is known as bronchus-associated lymphoid tissue lymphoma), thyroid, and, less frequently, the skin or intestine. Approximately 35–50% of cases occur in the stomach.

Accurate staging remains challenging due to the diseaseʼs indolent nature and variable metabolic activity. While CT is the first-line imaging modality for staging, it cannot reliably differentiate MALT lymphoma from reactive hyperplasia or other low-grade lymphomas. Meanwhile, FDG PET/CT aids in detecting occult lesions and identifying transformation to aggressive lymphoma (e.g., diffuse large B-cell lymphoma) but it has limited sensitivity for low-volume or indolent disease [3].

A 60-year-old man was referred following a routine chest radiograph. The imaging revealed a pulmonary nodule in the right middle lobe. After lobectomy and lymph node sampling, histological analysis confirmed the lesion as pulmonary MALT lymphoma.

Publikationsverlauf

Eingereicht: 06. März 2025

Angenommen nach Revision: 14. August 2025

Artikel online veröffentlicht:
28. August 2025

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