For the treatment of a MALT tumor, what should be checked first?

In the case of MALT (mucosa-associated lymphoid tissue) lymphoma, particularly when it arises in the context of the stomach, checking for H. pylori infection first is crucial. The majority of gastric MALT lymphoma cases are associated with chronic infection by H. pylori. Successful eradication of the bacteria often leads to regression of the lymphoma, making it a pivotal step in the management of this condition.

Determining the presence of H. pylori can significantly influence treatment decisions. If the infection is confirmed, treating it with antibiotics and proton pump inhibitors could potentially resolve the lymphoma without the need for more aggressive interventions like chemotherapy or radiation.

The necessity to assess tumor size, symptoms, or perform imaging like a CT scan typically follows the evaluation for H. pylori, as these assessments would take place after addressing the underlying infectious etiology if present. Thus, screening for H. pylori infection is a prioritized step in the evaluation and management of MALT lymphoma.