肝膿瘍にて発症したEBV関連胃癌の1例

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  • A CASE OF EPSTEIN-BARR VIRUS-ASSOCIATED GASTRIC CARCINOMA PRESENTED WITH LIVER ABSCESS

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A healthy 72-year-old man was admitted to the hospital because of high fever. Abdominal ultrasonography US and CT scan revealed a 5×4cm solitary liver abscess. Gastric endoscopy revealed an ulcerative lesion in the upper body of the stomach, and a biopsy disclosed fragments of adenocarcinoma. Following administration of antibiotics, his general condition became stable and the liver abscess decreased. Percutaneous liver biopsy was negative for malingancy. Total gastrectomy was performed and histopathologic examinations revealed poorly differentiated adenocarcinoma with lymphoid stroma, and positive in situ hybridization EBER. As of 8 months after the operation, he remains well with no clinical evidence of recurrence. In this patient, bacterial invasion of the liver parenchyma might have occurred through the portal system from the “broken” mucosal barrier in gastric cancer.

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