Abstract
The patient was a 57-year-old woman who consulted a nearby physician with chief complaints of dyspnoea and general malaise. Chest X-ray and chest CT indicated a tumour shadow in the left lung, and she was referred to our hospital. Mucosa-associated lymphoid tissue (MALT) lymphoma was diagnosed by bronchial endoscopic biopsy. Upper gastrointestinal tract endoscopy showed extensive MALT lymphoma from the upper body of the stomach to the antrum and 0-IIa+IIc gastric cancer in the convexity. Histopatholigical examination showed that the MALT lymphoma was identical to the pulmonary lesion, and they were considered to be gastric and pulmonary MALT lymphoma of unknown primary origin. The gastric cancer was moderately differentiated adenocarcinoma. CHOP therapy was decided because the gastric MALT lymphoma was Stage IV. Gastrectomy was performed prior to CHOP therapy since the gastric cancer was suspected to have invaded below the submucosa. Examination of the excited specimen demonstrated the invasion of gastric cancer to the muscularis propria, but no lymph node metastasis. On the other hand, lymphoma was found to have metastasized to lymph nodes, with prominent vascular invasion.
We report a rare case of advanced and extensive gastric MALT lymphoma complicating gastric cancer that was discovered through pulmonary lesion.
