Abstract
We report an interesting case of gastric malignant lymphoma that was able to be followed up without treatment by the endoscopic findings. A 81-year-old woman was admitted to our hospital because of a further examination of gastric ulcer lesion. Histopathological and immunohistochemical examination of biopsy specimens showed a gastric malignant lymphoma (diffuse large B cell type). She and her family refused specific treatments (chemotherapy or surgical resection), that made us observe the natural course of gastric lymphoma by upper gastrointestinal endoscopy. Serial endoscopic findings for about one year revealed that the morphology of lymphoma lesion changed remarkably with time. It changed from submucosal lesion, mucosal elevated lesion, ulcerations with thicking and extensive ulcer with invasion to surroundings, to repaired ulcer scar with discoloration. This finding of lymphoma process suggests that various appearances of lymphoma lesion may depend upon multiple phases of lymphoma progression.
