A CASE OF PRIMARY GASTRIC T-CELL LYMPHOMA (PGTCL) WITHOUT ANTI-HUMAN T-LYMPHOTROPIC VIRUS TYPE-1 (HTLV-1) ANTIBODY

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  • 抗human T-lymphotropic virus type-1(HTLV-1)抗体陰性の胃原発T細胞リンパ腫の1例

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Abstract

This paper presents a case of primary gastric T-cell lymphoma with negative HTLV-1 antibody, together with a review of 17 cases in the Japanese literature. A 67-year-old man was admitted to the hospital because of upper abdominal distress. A large tumor resembling type 2 of gastric cancer was detected at the body of stomach by upper G-I series and endoscopy. The biopsy revealed malignant lymphoma. No other lesions were noted except regional lymph node swelling by CT-scan. Serology was negative for HTLV-1 antibody. A total gastrectomy with a splenectomy and a partial hepatic resection, and lymph node dissection were performed. Histology of the resected material revealed diffuse and mixed cell type of lymphoma. Surface markers for lymphocyte were CD20-/CD3+ and CD4+/CD8-, showing T-cell lymphoma. Nodal recurrences appeared in the cervical region six and 11 months after the surgery. The patient responded well to the CHOP, and then a second-line chemotherapy. He has been living well with a partial response for the postoperative 22 months.<BR>The present case showed almost similar clinicopathologic features to the reported cases. Six-,12and 24-months survival rates of these cases, consisted mainly of Stage IIEs (Ann-Arbor), were 82.5 62.9 and 62.9%, respectively. Therefore, gastrectomy followed by an appropriate chemotherapy was considered to be a treatment of choice for this Stage. Further accumulation of cases would be necessary for determining the treatment or the prognosis of this disease.

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