Protruded Type of Early Malignant Lymphoma of the Stomach : Report of a Case

Abstract

A 59-year-old male was admitted to our hospital for further evaluation and treatment of a protruding gastric lesion. This lesion was first detected in a screeing radiographic examination.
A protruding gastric lesion with an irregular surface was observed during an endoscopic examination of the upper gastrointestinal tract. A biopsy specimen was obtained. Histological examination of this biopsy specimen revealed a malignant lymphoma of the stomach (non-Hodgkin, diffuse medium sized cell type. As based on the Lymphoma Study Group classification) . Subsequently, the patient underwent operative treatment. Gross examination of the surgical specimen showed a flat protruding lesion with an irregular surface. The depth of tumor penetration was limited to the sm. No lymph node metastasis was observed. We diagnosed the tumor to be an early gastric malignant lymphoma.
With the increasing prevalence of health screening examination and more widespread use of the endoscopic technique for evaluating upper gastrointestinal disease in recent years, the rate of detection of early gastric malignant lymphoma has increased. The histopathological findings of early gastric malignant lymphoma are most often similar to those found in type IIc early gastric cancer. The finding of our patient were unique in that they resembled those of type IIa early gastric cancer. Our review of the literature revealed only 6 other such cases in Japan. Thus our case may be considered a relatively rare occurrence. The literature regarding similar case was also reviewed.