Pediatric gastric MALT lymphoma: an antibiotic-treatable lymphoma, a case report and review of the literature

To summarize descriptively the clinical characteristics, diagnosis, and treatment of pediatric gastric mucosa-associated lymphoid tissue (MALT) lymphoma. We report and analyze the clinical management and 3-year follow-up data of one pediatric gastric MALT lymphoma case. Additionally, we conducted a comprehensive review of the literature by searching PubMed, Embase, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), Chinese VIP Information Database (VIP), and Wan Fang Med Database (Wan Fang) from inception until August 6, 2025, for case reports and case series on pediatric gastric MALT lymphoma. The clinical features of identified cases were summarized descriptively. A 13-year-old boy was diagnosed with gastric extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), positive for Helicobacter pylori (H. pylori). After H. pylori eradication, two follow-up gastroscopies over 3 years showed complete regression of the gastric MALT lymphoma and negative H. pylori status. At the 3-year follow-up, the patient exhibited good growth and development and remains under clinical surveillance. Literature review identified 18 articles (published 1984–2024), reporting 26 pediatric patients (14 males). Most patients were school-aged or adolescents, with a predominance of Asian cases. The main clinical presentation was epigastric and periumbilical pain. Gastroscopic findings were non-specific, with lesions most commonly located in the gastric antrum and body. Approximately 85% of patients had H. pylori infection. Clinical stages were generally early, with localized disease. All patients achieved favorable long-term outcomes after H. pylori eradication therapy during follow-up. Pediatric gastric MALT lymphoma is rare, typically presents at an early stage, and is strongly associated with H. pylori infection. Eradication of H. pylori is the first-line therapy. Long-term follow-up after anti-H. pylori treatment is essential.