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Successful Management of Primary Gastric Burkitt's Lymphoma Using Aggressive Chemotherapy in the Early Phase, Report of a Case Hiroyuki Aoyagi 1 , Yasuharu Kaizaki 2 , Manami Utsunomiya 1 , Atsushi Arizuka 1 , Yasuhito Takeda 1 , Yoshihide Naitoh 1 , Akihiro Tanaka 1 , Haruo Fujinaga 1 , Hajime Sunagozaka 1 , Kenkei Hasatani 1 , Sei Tatsumi 1 , Kouji Morinaga 3 1Department of Gastroenterology, Fukui Prefectural Hospital, Fukui, Japan 2Department of Pathology, Fukui Prefectural Hospital, Fukui, Japan 3Department of Hematology and Oncology, Fukui Prefectural Hospital, Fukui, Japan Keyword: 胃原発Burkittリンパ腫 , 早期治療介入 , 内視鏡診断 , starry sky appearance pp.1475-1483
Published Date 2021/10/25
DOI https://doi.org/10.11477/mf.1403202583
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 We report a rare case of BL(Burkitt's lymphoma)of the stomach in a woman in her 70s that was successfully managed by early chemotherapeutic intervention. Esophagogastroduodenoscopy for epigastralgia in our patient revealed a 50mm flat elevated lesion with a shallow depression in the lesser curvature of the upper gastric body under white light imaging. The lesion had a granular surface, a reddish mucosa with erosion, and a shallow ulcer. M-NBI(narrow band imaging with magnification)showed an irregular microsurface and an irregular microvascular pattern with a demarcation line. Importantly, findings in the vessels within epithelial circle were similar to those in the depressed lesion. After 9 days, the lesion increased in size and the ulceration deepened. No surface structure was observed and M-NBI showed the presence of extended blood vessels at the margin of the lesion. Histological analysis of the revealed medium-to-large sized lymphocyte infiltration with “starry sky” macrophages. The lesion was accurately diagnosed as BL based on immunohistochemical analysis and the diagnosis was confirmed by molecular FISH analysis, which detected DNA rearrangements in the MYC gene. The patient was provided intensive multi-agent chemotherapy, including R-hyper CVAD and DA EPOCH-R. Currently, at 3 years and 10 months after chemotherapy initiation, she remains alive and well despite a Dumbbell-like shaped stomach. This case report indicates that gastric BL can be successfully managed if aggressively treated in the early stages.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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