A Case Report of Malignant Lymphoma of the Stomach with Difficulty of Differential Diagnosis with RLH

Kazuya Kato, Minoru Matsuda, Kazuhiko Onodera, Shinichi Kasai, Michio Mito*, Akira Hotozuka**, Tatsuo Kobayashi***

*Second Department of Surgery, Asahikawa Medical College
**Department of Neurosurgery, Asahikawa Medical College
***Kobayashi Hospital

Malignant lymphomas of the stomach are infrequently encountered. They represent one percent of all gastric neoplasmas. We report a case of malignant lymphoma of the stomach with reactive lymphoreticular hyperplasia (RLH) that was very difficult to diagnose histologically and even by immunohistologically. The patient was suffered from herpes zoster infection, which developed to encephalomyelitis. A 76-year-old man presented with upper abdominal pain. Upper gastrointestinal study (barium, endoscopy and abdominal CT) revealed a submucosal tumor of the stomach. Histological findings of the biopsy specimen showed RLH or low grade mucosa-associated lymphoid tissue (MALT) lymphoma. Surgery was performed. The final diagnosis was malignant lymphoma of the stomach (B cell type lymphoma, small cell type) by using the immunohistologically technique. This case suggested that RLH may be an early stage lesion of malignant lymphoma of the stomach.

Key words
malignant lymphoma of the stomach, reactive lymphoreticular hyperplasia, herpes zoster encephalitis

Reprint requests
Kazuya Kato Second Deparment of Surgery, Asahikawa Medical College
4-5 Nishi-Kagura, Asahikawa, 078 JAPAN

Accepted
September 14, 1994

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