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Superficial Spreading Type of Malignant Lymphoma of the Stomach, Associated with Reactive Lymphoid Hyperplasia T. Katsumata 1 , M. Hayashi 1 , K. Saigenji 1 , H. Okabe 1 , N. Soma 2 , Y. Sakakibara 2 , M. Oida 3 , H. Atari 3 1Department of Internal Medicine, School of Medicine, Kitasato University 2Department of Surgery, School of Medicine, Kitasato University 3Department of Pathology, School of Medicine, Kitasato University pp.459-463
Published Date 1981/4/25
DOI https://doi.org/10.11477/mf.1403108019
  • Abstract
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 A 26 year-old male was admitted to Kitasato University Hospital on July 3, 1980, with chief complaint of hunger pain in epigastrium. Physical examination was negative except for soft enlargement of thyroid. Laboratory data showed no remarkable change.

 On upper gastrointestinal series, multiple nodules in different sizes accompanied with irregular shallow ulcerations were demonstrated from the lower part of the gastric body to the antrum. These multiple nodules at the anal portion of the antrum became smaller and more unform than at the gastric angle. The gastric walls expanded well and the borderline between the lesions and the normal mucosa was not so clear partially. From these findings, we suspected this lesions for malignant lymphoma rather than Ⅱc-type gastric cancer radiographically.

 Biopsy specimen also revealed suspicion of malignant lymphoma, but pathologist also pointed out possibility of reactive lymphoid hyperplasia.

 Barium meal study of the small intestine showed mesenterium commune of non-rotated type and soft polypoid lesions (varices) of the third portion of the duodenum.

 Subtotal gastrectomy was performed on September 1, 1980.

 Histological examination revealed a diagnosis of malignant lymphoma of the stomach, accompanied with RLH chiefly close to its anal portion. Tumor cells infiltration limited to the mucosa and submucosal layer, and no lymph-node involvement was noticed.

 We showed the border area between malignant lymphoma and RLH microscopically, and discussed the possibility of malignant change of RLH.


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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