A CASE OF MALIGNANT LYMPHOMA OF THE STOMACH IN WHICH GASTRECTOMY FOR PYLORIC STENOSIS AFTER CHEMOTHERAPY RESULTED IN HISTOLOGICAL COMPLETE REMISSION

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  • 化学療法後に幽門部狭窄をきたしたため胃切除術を行い組織学的に完全寛解が確認された胃悪性リンパ腫の１例

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Abstract

A 59-year-old man was examined for epigastralgia. Gastric endoscopy visualized an giant ulcer from the corpus to the antrum of the stomach. A histological diagnosis of malignant lymphoma (diffuse large B cell type CD 20 antibody-positive) was made based on the biopsy specimen, after which he was admitted to our hospital for chemotherapy. After 3 cycles of treatment, he was admitted for nausea and vomiting after eating frequently. Endoscopy revealed a significant diminution of the ulcer and gastric outlet stenosis in the lesion. From these studies, we diagnosed this as gastric outlet stenosis due to a tumor and performed distal gastrectomy with D1+α lymph node dissection. Histopathologically, no lymphoma cells were detected through all sections of the specimen and regional lymph nodes. We regarded it as a case of complete remission. This case suggests that chemotherapy is effective in treating malignant lymphoma of the stomach, and demonstrates the possibility that primary lesion may form a scar as gastric outlet stenosis after chemotherapy.

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