Case 146 – update 3

This lady has had a partial response after eradication therapy but is asymptomatic, so continues active monitoring with 3-monthly OGDs.

After about 12 months, she becomes symptomatic again with abdominal discomfort. CT scanning shows gastric wall thickening and perigastric lymphadenopathy only. Biopsy shows progression of her previously diagnosed lymphoma.

What treatment would you offer at this point?

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