39. A 40-year-old woman presents with wlao a chronic non-healing gastric ulcer. Biopsy at the edge of the ulcer
reveals dense lymphoid infiltrates infiltrates forming lymphoepithelial lesions. Immunostaining shows a marginal
zone B-cell lymphoma. Which underlying condition most likely contributed to the pathogenesis of this
tumor?

(A) Autoimmune destruction destruction ofof parietal parietal cecells in pernicious anemia
(B) Chronic Helicobacter pylori infection

(C) Epstein-Barr virus latent infection of B cells

(D) Celiac disease with villous atrophy