A 55-year-old man is diagnosed with Helicobacter pylori-positive gastric mucosa-associated lymphoid tissue (MALT) lymphoma confined to the stomach (stage IE). There is no evidence of transformation. What is the recommended first-line treatment?

• A Total gastrectomy with D2 lymphadenectomy
• B Involved-field radiation therapy
• C R-CHOP chemotherapy
• D H. pylori eradication therapy with antibiotics and PPI ✓

Explanation

H. pylori eradication is first-line for localized gastric MALT lymphoma, achieving complete remission in 60-80% of cases. The lymphoma is antigen-driven by H. pylori. Surgery and radiation are reserved for refractory cases. R-CHOP is used for diffuse large B-cell lymphoma, not MALToma. Follow-up endoscopy confirms regression.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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