Secondary achalasia in non-Hodgkin's lymphoma of low malignancy and leiomyomatosis of the cardia

A 28-year-old man had been dysphagic for 9 months with a weight loss of 4 kg. A preliminary diagnosis of primary achalasia was made on the basis of typical radiological and manometric findings. Despite balloon dilatation of the cardia the symptoms did not improve and further diagnostic tests were pe...

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Bibliographic Details
Published inDeutsche medizinische Wochenschrift Vol. 117; no. 18; p. 698
Main Authors Junginger, T, Maurer, K P, Eckardt, V F, Rumpelt, H J
Format Journal Article
LanguageGerman
Published Germany 30.04.1992
Subjects
Adult
Cardia - pathology
Esophageal Achalasia - etiology
Follow-Up Studies
Gastrectomy
Gastric Mucosa - pathology
Humans
Leiomyoma - complications
Leiomyoma - pathology
Leiomyoma - surgery
Lymphoma, B-Cell - complications
Lymphoma, B-Cell - pathology
Lymphoma, B-Cell - surgery
Male
Neoplasms, Multiple Primary
Stomach - pathology
Stomach Neoplasms - complications
Stomach Neoplasms - pathology
Time Factors
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Summary:A 28-year-old man had been dysphagic for 9 months with a weight loss of 4 kg. A preliminary diagnosis of primary achalasia was made on the basis of typical radiological and manometric findings. Despite balloon dilatation of the cardia the symptoms did not improve and further diagnostic tests were performed. Ultrasound demonstrated a 4 cm tumour below the cardia. But its type and possible malignancy remained uncertain even at laparotomy. But as a malignant tumour was suspected a gastrectomy and omentectomy with removal of the local and regional lymph nodes were performed. After this the symptoms regressed and postoperative food intake was without problem. Histological examination of the surgical specimen revealed leiomyomatosis of the cardia and the gastric fundus, combined with a low-malignant B-cell lymphoma of the mucosa-associated lymphatic tissue. Oesophagus manometry 4 months postoperatively gave normal results. The patient has been free of symptoms and without evidence of recurrence for by now 18 months postoperatively.
ISSN:0012-0472