Abstract
A 91-year-old woman was admitted for severe epigastric pain. Abdominal enhanced CT showed a thickened stomach wall, free air, and ascites around the liver and right kidney. Emergent surgery was conducted, and a perforation in the middle part of the stomach was found. In addition, a diffusely hard mass was attached to the perforated area. A gastric cancer was suspected, and a distal gastrectomy with D1 lymph node dissection was performed. On pathology a diffuse large B-cell lymphoma was diagnosed. Based on the Lugano International Classification, since lymphnode metastases were present at the greater curvature of the stomach without distant metastasis the Stage was II1E. The patient is currently well with no sign of recurrence, 8 months after surgery.
We treated a rare case of gastric malignant lymphoma with spontaneous perforation. To obtain a better prognosis, adjuvant chemotherapy should be given after surgery.
