Japanese

A Case of Cancer of the Gastric Fornix Coexisting with Reactive Lymphoreticular Hyperplasia Simulating Advanced Borrmann Type II Carcinoma Seen in the Same Location H. Amakawa 1 , K. Morifuzi 1 , I. Ito 1 , S. Simajutsu 1 , H. Matsumura 1 , Y. Yokoyama 1 , Y. Hayashi 2 11st. Dept. of Surgery, Hiroshima University Medical School 22nd. Dept. of pathology, Hiroshima University Medical School pp.587-591
Published Date 1974/5/25
DOI https://doi.org/10.11477/mf.1403111839
  • Abstract
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 While there have been several reports of reactive Lymphoreticular hyperplasia coexisting with cancer both in the pyloric antrum, no mention has ever been made of their coexistence in the cardiac region. In this paper is presented a recently encountered case of the fornix associated with localized hypertrophic RLH(Nakamura's classification) in the same site simulating advanced carcinoma type II according to Borrmann's classification.

 Roentgenogram of the stomach revealed marked deformity of the fornix, while endoscopy showed an ulcer there with adjacent mucosa hardly altered. Operation was performed under a provisional diagnosis of advanced carcinoma. At laparotomy, an abscess was found between the gastric fornix and the posterior peritoneum. There was no cancer metastasis to the lymph nodes. Resected stomach showed on its greater curvature side in the fornix a deep ulcer, 0.7 by 1.0 cm. Macroscopically it was hard to ascertain if there had been perforation. Margins of the ulcer were not raised, and a relatively large mucosal fold formed an overhanging edge well over the ulcer floor. Histologically extensive lymphoreticular hyperplasia was noticed around the ulcer. Cancer tissue was found in a part of ulcer margins. Prominent hyperplasia of Lymphoreticular tissue, seen from the mucosal layer through the muscular coat and surrounding cancer nests, was accompanied with formation of lymph follicles. The whole picture thus suggested association of RLH with cancer. The muscular coat did not show any break-up, but perforation was suggested because an abscess was formed within it and on the serosal side was seen inflammatory cellular infiltration as well as granulation tissue.

 Histologically it was impossible to clarify whether cancer had preceded RLH or vice versa, although they were of the same location.


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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