Left: 46 year-old woman with several weeks of dysphagia (difficulty swallowing) and dyspepsia (indigestion). Endoscopy revealed this bilobed mucosal swelling in the proximal gastric body, which was soft and grossly appeared benign. Forceps biopsies showed a nondiagnostic lymphocytic infiltrate; more extensive biopsy with a snare wire confirmed lymphocytic lymphoma. Histology on the resected specimen was consistent with a low grade B cell malignant lymphoma of the mucosa associated lymphoid tissue (MALT) type.

Center: 83 year-old woman with asymptomatic iron-deficiency anemia. Endoscopy demonstrated several small antral gastric ulcers with raised surrounding mucosa. Biopsies revealed a dense lymphoid infiltrate, lymphoepithelial lesions with atypical lymphoid cells permeating glandular epithelium, consistent with a lowgrade malignant lymphoma of mucosa-associated lymphoid tissue (MALT). No Helicobacter pylori were identified.

Right: Gastric fundic tumor, shown here at retroflexion, in a 76 year old woman with loss of appetite, early satiety, weight loss and anemia, but no abdominal pain. The lesion was focally ulcerated and bleeding. Histology was consistent with a large B-cell lymphoma or MALT.