Abstract
A 45-year-old man was admitted to our hospital because of epigastric pain. Upper gastrointestinal endoscopy revealed several ulcers in the lesser curvature of the body and antrum of the stomach. Histologic analysis of biopsy specimens revealed T-cell type lymphoma. Anti-HTLV-1 antibody was positive in serum. Abnormal lymphocytes were not found in either peripheral blood or bone marrow. CT and PET showed no lymph node swelling or metastasis to other organs, except to the lymph nodes around the stomach. Primary gastric lymphoma was diagnosed, and we performed total gastrectomy, cholecystectomy with D2 lymph node dissection. HTLV-1 proviral DNA was positive in the resected specimen but negative in the peripheral blood, so he was given a diagnosis of HTLV-1 associated primary gastric lymphoma. After surgery, he was treated with 6 cycles of THP-COP as adjuvant chemotherapy, and he is alive without recurrence at 27 months. Treatment strategy for HTLV-1 associated primary gastric lymphoma has not been established because of its extremely rare occurrence. Further accumulation of cases is needed to establish a strategy for treating such conditions.
