Total gastrectomy with adjuvant chemotherapy is the treatment of choice [Ref: Sabiston 20th Ed. ; Schwaz 11th Ed. Stomach is the most common extranodal site of lymphoma. It is of two types - Primary & Secondary Primary gastric lymphoma - is lymphoma of the stomach which exhibits no evidence of liver, spleen, mediastinal lymph nodes or bone marrow involvement at the time of diagnosis (regional lymph node involvement may be present) Primary gastric lymphoma is mainly (>95%) Non-Hodgkin&;s lymphoma of B cell origin. Most of the primary lymphomas (about 60%) arise in MALT (mucosa associated lymphoid tissue). MALT is usually associated with chronic H. pylori infection. So low-grade MALT lymphomas are thought to arise because of chronic H. pylori infection. These low grade lymphomas may later on degenerate to high grade lymphomas Immunodeficiency and H. pylori infection are risk factors for B cell lymphoma. Most common site of involvement (like that of adenocarcinoma) is gastric antrum. Secondary gastric lymphoma Stomach is the most common extranodal site of systemic lymphoma. Almost all of them are Non-Hodgkins types Treatment The role of gastric resection is controversial. Recent studies have shown similar disease free 5 year survival rates in patients treated with surgery+chemotherapy+radiotherapy and patients treated with chemotherapy+ radiation therapy alone. (Most patients with high grade gastric lymphomas are now treated with chemoradiation alone, without surgical resection. For disease limited to the stomach and regional nodes, radical subtotal gastrectomy may be performed, especially for bulky tumors with bleeding and/or obstruction.) Most common chemotherapeutic regimen is - CHOP plus rituximab [CHOP stands for cyclophosphamide, doxorubicin,vincristine