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A Case of Reticulum Cell Sarcoma of the Stomach Undergoing Changes within a Short Time S. Yamazaki 1 , O. Nakaizumi 1 , S. Sirasaki 2 1Dept. of Surgery, Fukui Pref. Hospital 2Dept. of Internal Medicine, Fukui Pref. Hospital pp.51-55
Published Date 1974/1/25
DOI https://doi.org/10.11477/mf.1403111729
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 A case of early reticulum cell sarcoma of the stomach is described that underwent remarkable changes within a short period of 50 days. A 39-year-old man noticed hunger pain in the epigastrium since about one month before. The initial endoscopy revealed a small protrusion on the anterior wall of the antrum. In one month it grew rapidly, simulating a Borrmann-type-Ⅱ neoplasm. He was admitted at once to the hospital for further workup. The verdict of biopsy on the following day was a tumor of benign nature. The gastric juice was of normal acidity. Two days before the surgical intervention the tumor was found to have undergone conspicuous change, x-ray demonstrating a shallow ulcer of irregular shape on the anterior wall of the antrum in addition to converging mucosal folds toward the ulcer. The tips of the folds showed a smooth hemispherical shape, convex toward the ulcer. They looked altogether like “the head of catfish”. As endoscopic features demonstrated on the day before the operation were the same, the tumor was clinically diagnosed as malignant lymphoma. Nonetheless, gastric biopsy on the same day judged it a benign growth. Histologically it proved to be reticulum cell sarcoma remaining within the submucosa. The tumor cells showed intramucosal invasion only in a very small part of the ulcer margin in the greater curvature side. They were also seen sparsely on the floor of Ul-Ⅱ ulcer. These findings probably account for the difficulty of diagnosis through biopsy. Some cases of malignant lymphoma of the stomach may exhibit “malignant cycle” as in gastric ulcer, showing a pattern of rapid development, breaking-down and ulceration.

 Of 12 so far reported cases of early malignant lymphoma of the stomach, biopsy was attempted in 5 and correct diagnosis was obtained in 2 (the rate of accurate diagnosis: 40%). If biopsy is performed at shorter intervals, the biopsy forceps more sharpedged, more abundant specimens taken from various spots especially aiming at the ulcer margins, and finally if histological interpretation is done more carefully, so then would the results of biopsy in early stage of malignant lymphoma surely improve


Copyright © 1974, 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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