Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons)
Online ISSN : 1882-9112
Print ISSN : 0385-7883
ISSN-L : 0385-7883
Primary Gastric T-cell Lymphoma without Human T-lymphotropic Virus type 1
Shuji SUZUKINobuhiko HARADAMamoru SUZUKI
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2006 Volume 31 Issue 5 Pages 835-840

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Abstract
Most primary gastric lymphomas are of B-cell origin and those of T-cell origin are very rare. We report a case of T-cell lymphoma without human T-lymphotropic virus type 1 (HTLV-1). A 73-year-old Japanese woman was admitted with epigastralgia and lumbago. Endoscopic examination visualized a submucosal tumor on the greater curvature of the cardia. Biopsy yielded a diagnosis of gastric malignant lymphoma. Lymph node swelling was recognized from the lesser curvature of the stomach to the lesion surrounding the aorta on computed tomography and ultrasonography, but no swelling of lymph nodes in the chest or superficial lymph nodes was seen. Total gastrectomy and local lymph node dissection was performed. HTLV-1 pro-viral DNA was negative in the resected specimen. Immunological findings in the resected specimen were positive in CD3, CD4, and negative in CD20, CD79α, and CD8. Gastric T-cell lymphoma without HTLV-1 was diagnosed. After the operation, chemotherapy was performed for lymph node swelling at the posterior of the pancreas head and surrounding the aorta. Two courses of chemotherapy (CHOP) yielded a complete response. The patient was well and disease free for 6 months, but she died 18 months after the operation with recurrence of lymph node swelling surrounding the aorta. Gastric T-cell lymphoma without HTLV-1 is associated with a poor prognosis in the literature.
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