A Case of Gastric Cancer Associated with Gastric Tuberculosis

Masami Asakawa, Iwao Kaneko, Toyofumi Takeyari, You Ichinose, Toshirou Tanaka, Hiroshi Setoyama, Michio Okabe and Naoki Hosaka^*

Department of Surgery, Toyooka Hospital Department of Clinical Patholpgy, Toyooka Hospital^*

In a case of gastric cancer associated with gastric tuberculosis, a 74-year-old woman was admitted to our hospital for dysphagia. Gastrointestinal fiberscopy revealed gastric cancer in the cardiac region with stenosis of the lower esophagus. Plain chest X-ray and chest computed tomography (CT) showed a linear high-density area in the lower left lung field. Esophageal stenting and chemotherapy were conducted preceding surgery. Lower esophagectomy and total gastrectomy with distal pancreatectomy and splenectomy were then done. Histological examination revealed tubercular lesions such as Langhans'giant cells and epithelioid granuloma in a gastric cancer lesion and regional lymph nodes. Although tubercle bacillus was not detected, the lesion was diagnosed as gastric tuberculosis basad on histopathogical findings. Pulmonary tuberculosis was inactive, so chemotherapy was not undertaken for tuberculosis. The patient is doing well without evidence of gastric cancer recurrence or of tubercular recrudescence in the 18 months since surgery. Coexistence of gastric cancer associated with gastric tuberculosis is rare, and this is only the 18th case reported in Japan to our knowledge.

Key words
gastric cancer associated with gastric tuberculosis, advanced gastric cancer, total gastrectomy

Reprint requests
Masami Asakawa First Department of Surgery, Yamanashi Medical University 1110 Shimokatou, Tamaho-town, Nakakomagun, Yamanashi, 409-3898 JAPAN

Accepted
June 26, 2001

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