Abstract
A 75-year-old woman was admitted for investigation of appetite loss and diarrhea. Chest X-ray and CT showed multiple patchy shadows in bilateral lungs. Gastrointestinal endoscopy showed multiple flat elevated lesions with the appearance of submucosal tumors in the gastric body, and a flat elevated lesion and an ulcerative lesion with the appearance of IIa and IIc tumors in the duodenum. Colonoscopy identified a flat elevated lesion in the cecum. Malignant lymphoma (diffuse large B-cell lymphoma : DLBCL) was diagnosed by histological analysis of the stomach, duodenal and large intestinal lesions. Gastric malignant lymphomas have been classified according to macroscopic appearance by Sano and Yao. Sano classified them into five categories (superficial, ulcer, polypoid, fungated and giant fold types). Gastrointestinal endoscopic findings of gastric DLBCL often reveal a single lesion, of the ulcer type according to Sano’s classification. This case is rare in that elevated lesions with the appearance of a submucosal tumor were observed relatively uniformly throughout the gastric body, along with endoscopic findings of gastric DLBCL and various other lesions extending to the duodenum and large intestine. This case of malignant lymphoma presented with various endoscopic findings extending to the stomach, duodenum and large intestine.
