Abstract
The patient was a 53-year-old woman who underwent laparoscopic-assisted distal gastrectomy for a submucosal tumor of the stomach and was diagnosed as having ectopic pancreas of the stomach. Three months later dull pain developed in the entire abdomen and an abdominal CT scan revealed a tumor like abscess in the abdominal cavity. The patient's clinical course was observed while she was on oral antimicrobial therapy. The tumor became smaller and the abdominal pain subsided. The tumor was movable so that mesenteric lesion was suspected. The tumor was still decreasing in size even after discontinuation of the antimicrobial therapy. However, abdominal CT scan performed in the sixth month after the initial CT scan showed new appearance of para-aortic lymph node swelling. We performed laparotomic biopsy by bearing a possible diagnosis of malignant lymphoma in mind. The movable lesion was clarified to be the swollen mesenteric lymph node. Histopathology disclosed both mesenteric and para-aotic lymph nodes to be diffuse large B-cell lymphoma. As of 10 months after the operation when eight courses of R-CHOP therapy had completed, complete cure has been kept. This is a case of malignant lymphoma in which we had difficulties in differentiating from postoperative abscess remnant from CT findings and clinical course.
