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Classification Scale for Gastric MALT Lymphoma

Purpose: To evaluate the lymphoid infiltrate in a gastric biopsy using the classification scale of Wotherspoon et al.

Description

Wotherspoon et al developed a simple scale for classification of gastric lymphoid infiltrates. This can help distinguish benign, reactive processes from true MALT (mucosa-associated lymphoid tissue) lymphomas. The authors are from University College Medical School in London and Ospedale Civile in Feltre, Italy.


 

Features

Description

Grade

scattered plasma cells in the lamina propria; no lymphoid follicles present

normal

0

small clusters of lymphocytes in the lamina propria; no lymphoid follicles present; no lymphoepithelial lesions present

chronic active gastritis

1

prominent lymphoid follicles with surrounding mantle zone and plasma cells; no lymphoepithelial lesions present

chronic active gastritis with florid lymphoid follicle formation

2

lymphoid follicles surrounded by small lymphocytes that infiltrate diffusely in the lamina propria and occasionally into the gastric epithelium

suspicious lymphoid infiltrate in the lamina propria, probably reactive

3

lymphoid follicles surrounded by centrocyte-like lymphocytes that infiltrate diffusely in the lamina propria and into the gastric epithelium in small groups

suspicious lymphoid infiltrate in the lamina propria, probably lymphoma

4

dense diffuse infiltrate of centrocyte-like lymphocytes in the lamina propria; prominent lymphoepithelial lesions present

low grade B-cell MALT lymphoma

5

 

where:

• A lymphoepithelial lesion is defined as unequivocal partial destruction of gastric glands or crypts by groups of centrocytic-type lymphocytes.

 


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Specialty

Objective

ICD-10