A Case of Gastric Lymphoma of Mucosa-Associated Lymphoid Tissue Exhibiting Marked Plasma Cell Differentiation with Idiopathic Portal Hypertension

Hirofumi Noguchi, Tadashi Horimi, Masaru Inagaki and Masahito Kotaka

Department of Surgery, Kochi Municipal Central Hospital

A case of gastric lymphoma of mucoa-associated lymphoid tissue (MALT) exhibiting marked plasma cell differentiation with idiopathic portal hypertension is reported. A 67-year-old woman was admitted to our hospital because of appetite loss and general fatigue. Upper gastrointestinal endoscopy revealed multiple stomach ulcers. Macroscopic examination revealed morphological similarities to the superficial type of malignant lymphoma. Abdominal CT and angiography showed splenomegaly and proliferation of the collateral vessels. Under the diagnosis of malingant lymphoma of the stomach and idiopathic portal hypertension, on the 29th of May, 1998. a total gastrectomy, lymphnode dissection (D2+α), splenectomy and liver biopsy was performed. The tumor was histopathologically classified as gastric lymphoma of MALT exhibiting marked plasma cell differentiation with monoclonality, the IgM-λ type. No abnormality of the liver was observed. The diagnosis was thus idiopathic portal hypertension. No case of gastric lymphoma of MALT exhibiting marked plasma cell differentiation with idiopathic portal hypertension has been reported and so this case is very important.

Key words
gastric lymphoma of mucosa-associated lymphoid tissue, plasmacytoma of the stomach, idiopathic portal hypertension

Reprint requests
Hirofumi Noguchi First Department of Surgery, Okayama University Medical School 2-5-1, Shikata-cho Okayama, 700-8558 JAPAN

Accepted
November 30, 1999

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