Abstract
A 56-year-old male was admitted to our hospital for the further examination of the elevated lesion at the gastric antrum which had been detected by X-ray and endoscopic examination. Superficial elevated type of early gastric cancer or atypical epithelium (ATP) were suspected. The endoscopic biopsy specimen showed atypical lymphoid cells and malignant lymphoma of the stomach was suspected. The endoscopic ultrasonography (EUS) findings revealed the thickening of the only 2nd layer of the gastric wall without change of the third layer. Subtotal gastrectomy was performed. Histopathologically, the lesion was diagnosed as malignant lymphoma, diffuse medium cell type and the tumor invasion was limited to the mucosa. Anti-ATL associated antigen (ATLA) antibody was positive and hemogram showed abnormal lymphocytes after surgery. The final diagnosis was made as the gastric invasion of adult T-cell leukemia (ATL). Application of EUS for the local lesion of gastric mucosa of ATL has not been so far reported. EUS was thought to be useful to diagnose the degree of intermural infiltration and to examine the progres-sive process of malignat lymphoma of the stomach.
