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Malignant Lymphoma of the Stomach Which Developed into Giant Rugal Type from Localized Thickening of the Mucosa in a Period of Two Years and Five Months T. Ninomiya 1 1Department of Internal Medicine, Cancer Institute Hospital pp.531-536
Published Date 1981/5/25
DOI https://doi.org/10.11477/mf.1403108049
  • Abstract
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 A 51-year-old male patient was admitted to the Dept. of Internal Medicine, Cancer Institute Hospital, Tokyo, on January 19, 1973, under the diagnosis of malignant lymphoma of the stomach. His chief complaint was anorexia and epigastric pain.

 In June 1970 he received health check, including upper G-I series. The stomach was reported to be normal. But endoscopy was recommended because of positive occult blood test. In September 1970 he had the first visit to the Dept. of Internal Medicine, C.I.H. for the detailed examination. The first x-ray (Sept. 10, 1970) and endoscopy (Sept. 12, 1970) were reported to be normal. The second x-ray done on December 4, 1971, revealed the localized thickening of the mucosa in the upper gastric body, and the diagnosis of submucosal tumor was made. But in the second endoscopy the abnormality detected by the x-ray was merely diagnosed as localized chronic hypertrophic gastritis. No further study had been done until August 1972 when he noticed anorexia and epigastric fullness. In September 1972 x-ray of the stomach was done in an other hospital. But no abnormality was detected.

 He had the third visit to the C.I.H. on December 25, 1972, because of epigastric pain which had appeared in the middle of December. The third x-ray of the stomach done on December 25, 1972, revealed markedly enlarged folds of the fornix and middle body which were strongly suggestive of malignancy.

 Physical examination on admission was normal except for slight tenderness in the upper epigastrium. Blood count, blood chemistry and urinalysis were normal. The fourth x-ray and endoscopy suggested malignant lymphoma and it was confirmed by endoscopic biopsy. Operation (total gastrectomy with combined resection of the distal esophagus and the tail of the pancreas, curative) was done on February 2,1973. Histologic examination of the resected material revealed malignant lymphoma, diffuse histiocytic type with extensive involvement of the mucosa and submucosa. and slight involvement of the propria muscle and subserosa. No metastasis was found in the dissected lymph nodes (0/23).


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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