How is gastric MALT lymphoma staged?

Updated: Feb 25, 2021
  • Author: Sanjay Vinjamaram, MD, MPH; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

The following two systems are currently used for staging gastric marginal zone lymphoma:

  • Lugano staging system (1994) [75]

  • Paris staging system (2003) [76]

The Lugano system is a modification of the Ann Arbor staging system, and the Paris system corresponds to the tumor-node-metastasis (TNM) system for staging gastric cancer, which presents more accurately the depth of gastric wall involvement, a factor in the response to H pylori eradication. See Table 2, below.

Table 2. Comparison of Lugano and Paris staging systems (Open Table in a new window)

Lugano Staging System

Paris Staging System

Stage

Area of Involvement

TNM

Tumor extension

IE1

Confined to GI tract—mucosa, submucosa

T1m N0 M0

T1sm N0 M0

Mucosa

Submucosa

IE2

Confined to GI tract—muscularis propria, serosa

T2 N0 M0

T3 N0 M0

Muscularis propria

Serosa

IIE1

Extending into abdomen—local nodal involvement

T1-3 N1 M0

Perigastric lymph nodes

IIE2

Extending into abdomen—distant nodal involvement

T1-3 N2 M0

More distant regional nodes

IIE

Penetration of serosa to involve adjacent organs or tissues

T4 N0 M0

Invasion of adjacent structures

IV

T1-4 N3 M0

T1-4 N0-3 M1

Lymph nodes on both sides of the diaphragm/distant metastases (eg, bone marrow or additional extranodal sites)


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