A CASE OF GASTRIC MALIGNANT LYMPHOMA WITH DIFFICULTIES OF THE PREOPERATIVE DIAGNOSIS

Gastric malignant lymphoma is a rare disease. Early gastric lymphoma of surface type is particularly difficult to determine operative indication because of difficulty in differentiating malignant lymphoma from benign diseases such as gastric ulcer and reactive lymphoreticular hyperplasia (RLH). We e...

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Published inJapanese Journal of National Medical Services Vol. 46; no. 2; pp. 121 - 124
Main Authors HARAUCHI, Daisaku, NIKI, Syunsuke, INOUE, Hiroyuki, OKUMURA, Hironobu, SUGIMOTO, Tomonori, MIKI, Hiroshi, KITA, Seizou
Format Journal Article
LanguageJapanese
Published Japanese Society of National Medical Services 1992
一般社団法人 国立医療学会
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Abstract Gastric malignant lymphoma is a rare disease. Early gastric lymphoma of surface type is particularly difficult to determine operative indication because of difficulty in differentiating malignant lymphoma from benign diseases such as gastric ulcer and reactive lymphoreticular hyperplasia (RLH). We experienced a case of early gastric malignant lymphoma that underwent curative operation because we suspected malignant disease from features of gastrofiberscopic and double contrast roentgenographic findings, though histological diagnoses from biopsy specimen were benign several times. The patient was a 59-year-old man. His chief complaints were hematemesis and abdominal pain. He had been treated at a nearby hospital with the diagnosis of gastric ulcer for eight months and was admitted to our hospital because of hematemesis at night. Histological diagnoses from gastrofiberscopic biopsies were Group j at first time and Group II at second time, but he was operated on because early gastric cancer of type II c was suspected by macroscopic findings. The pathohistological diagnosis was non-Hodgikin lymphoma. The infiltrating grade was sm. Lymph nodes metastasis was not seen. The histological staging was stage IE. It is more difficult to diagnose gastric lymphoma than gastric cancer. In particular, the diagnosis of early gastric lymphoma is needed with special emphasis on macroscopic features and complaints.
AbstractList Gastric malignant lymphoma is a rare disease. Early gastric lymphoma of surface type is particularly difficult to determine operative indication because of difficulty in differentiating malignant lymphoma from benign diseases such as gastric ulcer and reactive lymphoreticular hyperplasia (RLH). We experienced a case of early gastric malignant lymphoma that underwent curative operation because we suspected malignant disease from features of gastrofiberscopic and double contrast roentgenographic findings, though histological diagnoses from biopsy specimen were benign several times. The patient was a 59-year-old man. His chief complaints were hematemesis and abdominal pain. He had been treated at a nearby hospital with the diagnosis of gastric ulcer for eight months and was admitted to our hospital because of hematemesis at night. Histological diagnoses from gastrofiberscopic biopsies were Group j at first time and Group II at second time, but he was operated on because early gastric cancer of type II c was suspected by macroscopic findings. The pathohistological diagnosis was non-Hodgikin lymphoma. The infiltrating grade was sm. Lymph nodes metastasis was not seen. The histological staging was stage IE. It is more difficult to diagnose gastric lymphoma than gastric cancer. In particular, the diagnosis of early gastric lymphoma is needed with special emphasis on macroscopic features and complaints.
Gastric malignant lymphoma is a rare disease. Early gastric lymphoma of surface type is particularly difficult to determine operative indication because of difficulty in differentiating malignant lymphoma from benign diseases such as gastric ulcer and reactive lymphoreticular hyperplasia (RLH). We experienced a case of early gastric malignant lymphoma that underwent curative operation because we suspected malignant disease from features of gastrofiberscopic and double contrast roentgenographic findings, though histological diagnoses from biopsy specimen were benign several times. The patient was a 59-year-old man. His chief complaints were hematemesis and abdominal pain. He had been treated at a nearby hospital with the diagnosis of gastric ulcer for eight months and was admitted to our hospital because of hematemesis at night.Histological diagnoses from gastrofiberscopic biopsies were Group j at first time and Group II at second time, but he was operated on because early gastric cancer of type II c was suspected by macroscopic findings. The pathohistological diagnosis was non-Hodgikin lymphoma. The infiltrating grade was sm. Lymph nodes metastasis was not seen. The histological staging was stage IE. It is more difficult to diagnose gastric lymphoma than gastric cancer. In particular, the diagnosis of early gastric lymphoma is needed with special emphasis on macroscopic features and complaints. 胃悪性リンパ腫は, 比較的まれな疾患である. そのなかでも表層型早期悪性リンパ腫は, 胃潰瘍や反応性リンパ細網細胞増殖症(RLH)などの良性疾患との鑑別が困難であるため, 手術適応め決定に難渋する. 今回, 度重なる生検組織診断では良性であったが, 画像診断にて悪性疾患を疑い根治手術が行えた症例を経験した. 症例は, 59歳の男性. 主訴は吐血, 腹痛. 近医にて, 胃潰瘍として8ヵ月治療を受けていたが, 夜間に吐血したため当院に緊急入院となった. 当院での生検は, 初回Group I, 2回目Group II (RLH)であったが, 肉眼所見でII c型早期胃癌が疑われたため手術を施行した. 組織所見は, Non-Hodgikinリンパ腫, 深達度Sm, リンパ節転移なく, stage IEであった. 胃悪性リンパ腫は, 胃癌に比べて生検組織診断が困難である. 特に, 早期リンパ腫の場合は, 肉眼所見や臨床症状を重視して診断する必要がある.
Author KITA, Seizou
SUGIMOTO, Tomonori
NIKI, Syunsuke
HARAUCHI, Daisaku
INOUE, Hiroyuki
MIKI, Hiroshi
OKUMURA, Hironobu
Author_FL 三木 啓司
喜多 青三
杉本 友則
原内 大作
奥村 博信
井上 洋行
仁木 俊介
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DocumentTitleAlternate 術前診断が困難であった早期胃悪性リンパ腫の1例
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一般社団法人 国立医療学会
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References 4) 佐野量三: 胃疾患の臨床病理, 医学書院, 東京, 1974
3) 小黒八七郎他: 胃悪性リンパ腫の肉眼形態と臨床診断―特に早期胃悪性リンパ腫について―, 臨成人病, 15: 985, 1985
5) 山口肇他: 胃悪性リンパ腫の内視鏡的鑑別診断, 臨消内科, 2: 1269, 1987
2) 小林美樹他: 胃悪性リンパ腫の検討, 秋田医, 16: 667, 1989
6) 檜山護他: 胃悪性リンパ腫の内視鏡診断と生検, 胃と腸, 8: 165, 1973
7) 飯田三雄他: 胃原発性悪性リンパ腫と胃reactive lymphoreticular hyperplasiaの鑑別診断, 胃と腸, 16: 389, 1981
1) 清水重臣他: 原発性胃悪性リンパ腫の内視鏡診断上の問題点, 大警病医誌, 13: 47, 1989
8) 梅山馨他: 胃悪性リンパ腫の検討―臨床病理組織所見を中心に―, 消外, 8: 21, 1985
References_xml – reference: 1) 清水重臣他: 原発性胃悪性リンパ腫の内視鏡診断上の問題点, 大警病医誌, 13: 47, 1989
– reference: 3) 小黒八七郎他: 胃悪性リンパ腫の肉眼形態と臨床診断―特に早期胃悪性リンパ腫について―, 臨成人病, 15: 985, 1985
– reference: 4) 佐野量三: 胃疾患の臨床病理, 医学書院, 東京, 1974
– reference: 7) 飯田三雄他: 胃原発性悪性リンパ腫と胃reactive lymphoreticular hyperplasiaの鑑別診断, 胃と腸, 16: 389, 1981
– reference: 6) 檜山護他: 胃悪性リンパ腫の内視鏡診断と生検, 胃と腸, 8: 165, 1973
– reference: 8) 梅山馨他: 胃悪性リンパ腫の検討―臨床病理組織所見を中心に―, 消外, 8: 21, 1985
– reference: 2) 小林美樹他: 胃悪性リンパ腫の検討, 秋田医, 16: 667, 1989
– reference: 5) 山口肇他: 胃悪性リンパ腫の内視鏡的鑑別診断, 臨消内科, 2: 1269, 1987
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Snippet Gastric malignant lymphoma is a rare disease. Early gastric lymphoma of surface type is particularly difficult to determine operative indication because of...
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StartPage 121
SubjectTerms early malignant lymphoma
gastric malignant lymphoma
reactive lymphoreticular hyperplasia (RLH)
反応性リンパ細網細胞増殖症(RLH)
早期悪性リンパ腫
胃悪性リンパ腫
Title A CASE OF GASTRIC MALIGNANT LYMPHOMA WITH DIFFICULTIES OF THE PREOPERATIVE DIAGNOSIS
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