A Case of Gastric Malignant Lymphoma Complicated with Gastro-bronchial Fistula during Neoadjuvant Chemotherapy

Yongxin Chen, Seiji Sato, Daisuke Mori, Genichiro Edakuni, Kenji Kitahara, Katsuhiko Hidaka and Kohji Miyazaki

Department of Surgery, Saga Medical School

Gastric magilnant lymphoma is rare especially when complicated with gastro-bronchial fistula. An 80-year-old woman was referred to our hospital with chief complaints of nausea and anorexia. After careful examinations, gastric malignant lymphoma and advanced colon cancer were diagnosed. On abdominal CT, tumors of the stomach were suspected of invading the spleen, pancreas and the diaphragm. According to the Classification of Gastric Carcinoma, the gastric tumors were judged beyond stage IIIa. Right-hemi colectomy for the colon cancer followed by preoperative chemotherapy for the gastric malignant lymphoma were proposed as the therapeutic strategy. During chemotherapy, perforation of the stomach was suspected, but conservative therapy was selected since the inflammation had been localized. At the end of 4 cycles of THP-COP chemotherapy, gastro-bronchial fistula was noticed. Total gastrectomy, splenectomy and closure of the fistula were ferformed. Although complications occurred, preoperative chemotherapy for the gastric malignant lymphoma was successful.

Key words
gastric malignant lymphoma, neoadjuvant chemotherapy, gastro-bronchial fistula

Reprint requests
Yongxin Chen Department of General Surgery, Saga Medical School 5-1-1 Nabeshima, Saga, 849-8501 JAPAN

Accepted
April 28, 1999

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