Malignant Lymphoma Showing Giant Rugal Pattern T. Ninomiya 1 1Department of Internal Medicine, Cancer Institute Hospital pp.955-958
Published Date 1980/9/25
DOI https://doi.org/10.11477/mf.1403112791
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 A 61 year-old male patient was admitted to the dep. of surgery, Cancer Institute Hospital on No-vember 13, 1967, with the chief complaint of epigastric heaviness and pain after taking alcohol which had started since the beginning of May, 1967.

 On May 5, 1967, he was examined with x-ray by the neighboring doctor, and the diagnosis of peptic ulcer was made. Medical treatment had been continued until the beginning of November, 1967, when the second x-ray examination suggested the necessity of operation.

 On the x-ray and endoscopic examination after admission, the diagnosis of linitis plastica type carcinoma was made. Biopsy was negative for malignancy. Operation was performed on November 28, 1967.

 At operation no mass was palpable in the stomach. Serosal surface presented tendon-like hardness. There were lymph nodes metastases at the root of the mesentery and the paraaortic region. Total gastrectomy with combined resection of the tail of the pancreas and spleen was done (N3, H0, P0, S1), resulting in relative curative operation.

 The operated stomach revealed edematous enlargement of the mucosal folds from the fornix to the gastric angle and slight depression of the angular region, showing the fine granularity. There was a shallow ulcer on the anterior wall of the gastric body. Histologically the lesion was diagnosed as malignant lymphoma (nodular, well differentiated, lymphocytic) involving almost upper two thirds of the stomach, measuring about 180×160 mm. The infiltration of the tumor involved the proper muscle layer. All dissected nodes were positive.

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