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The So-called Borderline Reactive Lymphoid Hyperplasia of the Stomach, Which Is Difficult to Determine Whether Benign or Malignant Histologically, Report of a Case T. Katsumata 1 , T. Takahashi 2 , Y. Hiki 2 , H. Okabe 1 1Department of Internal Medicine, School of Medicine, Kitasato University 2Department of Surgery, School of Medicine, Kitasato University pp.173-176
Published Date 1981/2/25
DOI https://doi.org/10.11477/mf.1403107940
  • Abstract
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 A 31 year-old male came to the Kitasato University Hospital with a chief complaint of epigastralgia. On physical examination, superficial lymphadenopathy fever and anemia were not recognized. Upper gastrointestinal series revealed rigidity of the gastric walls with some filling defects from the gastric angle to the antrum. On the double contrast as well as compression pictures, multiple irregularly shaped shallow ulcers surrounded by abnormal thickening and interruption of the mucosal folds were demonstrated. Borrmann 4-typed gastric cancer or malignant lymphoma of the stomach was suspected endoscopically.

 Subtotal gastrectomy was performed on July 4, 1973. Histologically, marked proliferation of the lymphoid tissues accompanying a number of plasma cells and eosinophiles infiltrate, were seen diffusely from the lamina propria to the subserosa. Many large atypical lymphoid cells and a few mitotic figures were seen, but neither monotonous proliferation nor vessel invasion of the atypical cells, which indicate malignancy, were not recognized. Associated ulcers were Ul-Ⅱ or Ul-Ⅲ, accompanied with moderate fibrosis in the submucosal layer. From these findings, we diagnosed this so-called borderline lesion, which was difficult to determine whether benign or malignant histologically.

 RLH of the stomach has been classified into two types by Nakamura (1966) in Japan. One of them was “diffuse and flat” form, another was “localized and hypertrophic” form. Our case was not belonged to Nakamura's classification, but resembled the Borrmann 4-typed gastric cancer or giant fold gastritis, which has been reported popularly as gastric pseudolymphoma in Europe.

 We termed this type of RLH of the stomach as “infiltrative and hypertrophic” form, having tumorforming tendency. As some of this type of lesions may possibly change to malignancy, an early operation or strict follow-up study should be necessary.


Copyright © 1981, 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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