A Case of Small Cell Carcinoma at the Esophagocardiac Junction with Sarcoid Reaction in the Spleen and the Regional Lymph Nodes

Akira Igarashi, Koichi Okuda, Makoto Nishiwaki, Kazuyuki Tsujitsuka, Tokuhiko Kiyono, Masao Sumiyama and Yoshimune Horibe^*

Department of Surgery, Hamamatsu Red Cross Hospital^*Department of Pathology, Fujita Gakuen Health University School of Medicine

A 69-yaer-old woman visited a practitioner with a complaint of upper abdominal discomfort and was referred to our hospital. Upper gastrointestinal roentgenographic and endoscopic examinations revealed an elevated tumor at the esophagocardiac junction. Total gastrectomy and splenectomy were performed and resection of the pancreas tail was added. Histopathological diagnosis of the resected tumor (7.0× 7.5cm) was small cell carcinoma of the stomach. Although, no metastasis was found, sarcoid reactions comprised of epithelioid cells and giant cells observed in the regional lymph nodes. Sarcoid reaction is often found in the regional lymph nodes of various malignant tumors, but reports of sarcoid reaction in the spleen are few. The prognosis of small cell carcinoma of stomach is poor. On the other hand, sarcoid reaction is usually considered to indicate good prognosis. We report a case of small cell carcinoma of the stomach, which coexists with sarcoid reaction in the spleen.

Key words
small cell carcinoma, stomach, sarcoid reaction

Reprint requests
Akira Igarashi Department of Surgery, Hamamatsu Red Cross Hospital 902-6 Matsushita, Numazu, 410-0864 JAPAN

Accepted
December 9, 1998

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