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Reactive Lymphoreticular Hyperplasia, a Case Accurately Diagnosed by Biopsy H. Suzawa 1 , K. Shimizu 1 , S. Kusama 1 , F. Iida 2 , Y. Maruyama 3 1The First Dept. of Internal Medicine, Facul. of Med., Shinshu University 2The Second Dept. of Surgery, Facul. of Med., Shinshu University 3Central Clinical Labos., Facul. of Med., Shinshu University pp.449-453
Published Date 1975/4/25
DOI https://doi.org/10.11477/mf.1403112272
  • Abstract
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 A 63-year-old man was admitted to Shinshu University Hospital because of melena and hematemesis persisting on and off for 6 years.

 He was slightly anemic without any other clinical changes. The gastric juice was hypoaciditic.

 By x-ray examination of the stomach, a Ⅱc-like lesion was widely spread from the infracardiac portion to the antrum on both anterior and posterior walls. Gastrofiberscopically, the depressed area showed many varied appearances such as converging mucosal folds, erosions, minute ulcers, bleedings and white patches.

 These findings are considered but not conclusively diagnosed as Reactive Lymphoreticular Hyperplasia (RLH), and Ⅱc early carcinoma could not be ruled out. Biopsy revealed marked diffuse proliferation of lymphocytes invading the muscularis mucosae and we entertained a strong suspicion of the diffuse flat form of RLH. The atypia of these proliferating lymphocytes was not so evident and lymphosarcoma was excluded. On the gross appearance, the faintly depressed hyperemic lesion spread mostly all over the resected stomach mucosa except the prepyloric area. The boundary of the lesion was difficult to follow unlike that of Ⅱc carcinoma and many erosions and minute ulcers were scattered about.

 Histologically, remarkable proliferation of lymphocytes was observed on the mucosa and submucosa and follicular structures were locally seen. The lymphnodes showed diffuse hyperplasia of the lymphocytes in the pulp and the dilated sinuses were filled with small lymphocytes.

 The behavior of RLH has been discussed and the diffuse flat form of it is considered as kataplastic hyperplasia of the lymphoid tissue in the gastric mucosa.


Copyright © 1975, 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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