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Malignant Lymphoma Difficult to Differentiate from Lymphoid Hyperplasia S. Nakazawa 1 , S. Kawaguchi 1 , J. Yoshino 1 , T. Ichikawa 1 , M. Okada 1 1The Second Department of Internal Medicine, Nagoya University, School of Medicine pp.451-454
Published Date 1981/4/25
DOI https://doi.org/10.11477/mf.1403108017
  • Abstract
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 A 53 year-old woman visited our hospital with a complaint of hunger pain. Several erosions and ulcers in the body of stomach were found at x-ray and endoscopy examination and lymphoid hyperplasia (LH) was suspected from these findings. Biopsy from these lesions showed no value for correct diagnosis.

 After one year of follow-up, the x-ray examinations showed several small irregular barium flecks and various size of granulations on the lesser curvature of the upper part of the body. Similar lesions were also seen on the mid-body up to the lower part of body. Endoscopic examination showed several erosions with white coat, granulations and redness on the greater curvature of the lower part of the body. Shallow irregular depressions were newly checked on the lesser curvature of the upper part of the body in this examination.

 Pre-operative diagnosis was difficult. The characteristics of malignant lymphoma were not recognized, but biopsy examination revealed findings suggestive of malignant lymphoma.

 Subtotal gastrectomy was performed. Even in macroscopic examination, it was very difficult to differentiate malignant lymphoma from multiple ulceroerosive type of LH. With histological study, these lesions were limited to mucosal and submucosal layer in most part, but reached the muscular layer in part. The histological characteristics of LH were revealed, but in one part, those of malignant lymphoma were also seen because of atypia in the level of tumor cell and lymph follicles.

 On the whole, it might be more typical to diagnose such lesions as malignant lymphoma, but this case was an interesting one, when taking the histogenesis and the borderline lesions between LH and malignant lymphoma into consideration.


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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