Abstract
A71-year-old male was admitted to the Second Department of Surgery of Hiroshima University Hospital for further examination of the.gastric tumor. Radiological and endoscopic studies of the stomach showed an irregular-shaped ulcer with fold convergency on the anterior wall side of greater curvature and diamond-shaped ulcer on the posterior wall side of greater curvature of angular region. Histological studies of the biopsy specimens of the ulcer on the anterior wall side of greater curvature revealed malignant lymphoma and those of the ulcer on the posterior wall side of greater curvature did not contain malignant cells. Chest X-ray, abdominal ultrasonography and computer tomography revealed no lymphadenopathy. Therefore, we diagnosed the case as primary gastric malignant lymphoma and carried out subtotal gastrectomy with lymph nodes excision. The malignant lymphoma was ulcerative type of Sano's classification. Histological and immunohistochemical studies of the resected specimen showed that the lymphoma was diffuse, large-veil and T-cell hype and invaded into the proper muscle layer. The ulcer lesion on the posterior wall side of the greater curvature was benign UL-III ulcer. Five months after surgical operation, right pleural effsion with atypical lyphocytes appeared and chemotherapy was performed. Eight months after surgery, the patient is alive. Primary gastric T-cell lymphoma is very rare and only g cases, including our case, have been reported in Japan.
