Abstract
A 66-year-old man visited our hospital because of left hypochondric dull pain. A hen's egg sized mass was palpated in the left upper abdominal quadrant. Upper gastrointestinal series showed a hemispheric endophytic mass with clear margin on the greater curvature of the gastric body. A malignant submucosal gastric neoplasm was suspected because of a coarse shadow around the mass on abdominal CT scan and isotope accumulation by Gallium scintigram. Peripheral blood analysis did not reveal eosinophilia. Subtotal gastrectomy with lymphnode clearing was performed in April, 1988. The gastric wall had hardend around the greater curvature of the gastric body to form a mass of 5cm in diameter with the greater omentum. On microscopical examination, an abscess was identified in the subserosal layer of the gastric wall, and a diagnosis of nonspecific granuloma was made, accompanied by marked fibrosis and slight eosinocyte infiltration.
Although no colonies were identified, this lesion seemed similar to gastric actinomycosis. Culture of pus in the lesion may be of importance as actinomyces is hard to identfy on microscopical examination.
