A 50-year-old man undergoes endoscopy for dyspepsia showing a 1.5 cm sessile polypoid antral mass. Biopsy reveals a low-grade B-cell lymphoma. CT shows disease confined to the stomach and regional nodes. H. pylori testing is positive. What is the first-line treatment?
- A Total gastrectomy with D2 lymphadenectomy
- B H. pylori eradication therapy with triple regimen ✓
- C CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine, prednisolone)
- D Radiotherapy to the upper abdomen
Correct answer: B. H. pylori eradication therapy with triple regimen
Explanation
This describes gastric MALT (mucosa-associated lymphoid tissue) lymphoma, which is strongly associated with H. pylori infection. Localized MALToma achieves complete remission in 60-80% of cases with H. pylori eradication alone, making it the first-line treatment. Surgery, chemotherapy, and radiotherapy are reserved for refractory or high-grade transformed disease.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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