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A Case of Borderline Lymphoma Y. Tsugane 1 , S. Tsune 1 , M. Kitagawa 1 , S. Murohisa 1 , H. Ôkubo 2 1Dept. of Internal Medicine, Hamamatsu Medical Center 2Dept. of Clinical Laboratory, Hamamatsu Medical Center pp.249-254
Published Date 1978/2/25
DOI https://doi.org/10.11477/mf.1403107223
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 The patient, a 57-year-old housewife, was admitted to our hospital on Dec. 1, 1975, because of hunger pain in the epigastrium and weight loss of 20 kg for the past one year.

 The upper GI series showed numerous small and shallow ulcerations, accompanied with converging mucosal folds of which tips were enlarged. These ulcerations were widely spread from the infracardiac portion to the antrum on both aspects of anterior and posterior walls. The walls expanded well.

 Endoscopic examination showed in the same place multiple erosions and ulcerations accompanied with thickened, converging mucosal folds, and tendency to bleed easily. The biopsy and cytology examinations revealed findings suggestive of malignant lymphoma. Under a diagnosis of malignant lymphoma, total gastrectomy was performed. No swelling of resional lymphnodes was noted. In the resected specimen, multiple ulcers and erosions were noticed in the same area as we had expected preoperatively.

 The tips of the converging fold were enlarged and confluent and partially looked like bridging folds suggestive of a submucosal tumor.

 Histologically,12 ulcers were observed, all Ul-Ⅱ type of Murakami's classification. Lymphoid cells and reticulum cells were proliferating in the center of each ulcer independently or confluently and invading only the adjacent submucosal layer. As the histological characteristics of lymphoid tissue, the following findings were observed : in part lymphoreticular hyperplasia which had enlarged lymph follicles with germinal centers; in part diffuse proliferation of immature lymphocytes which was suggestive of malignant lymphoma; and in part intermingled features of the above. From these findings, this case was diagnosed as lymphoma which belonged to the border line region.


Copyright © 1978, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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