Korean J Helicobacter Up Gastrointest Res.  2021 Mar;21(1):86-92. 10.7704/kjhugr.2020.0054.

Gastric Mucosa-associated Lymphoid Tissue Lymphoma: An Important Differential Diagnosis for a Rapidly Growing Gastric Subepithelial Tumor - A Case Report and Literature Review

Affiliations
  • 1Department of Pathology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
  • 2Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
  • 3Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea

Abstract

Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade lymphoma with a long median survival time because of its low proliferation rate. A 75-year-old man was referred to the hospital for hematemesis. Upper endoscopy revealed a 30-mm subepithelial tumor (SET). Abdominal CT and EUS revealed a homogeneously hypoechoic lesion arising from the second layer of the stomach, without distant metastasis. Laparoscopic wedge resection was performed. On microscopic examination, the tumor showed diffuse aggregation of small lymphoid cells with abnormal architecture. Neoplastic cells showed positive reactivity for CD20 and prominent lymphoepithelial lesions were observed. The urease breath test was also conducted, with a negative result. Our final diagnosis was Helicobacter pylori-negative MALT lymphoma (Ann Arbor classification IE2), which is a rapidly growing SET pattern. This case highlights the importance of including gastric MALT lymphoma as a differential diagnosis for rapidly growing gastric SETs.

Keyword

Gastrointestinal stromal tumors; Hematemesis; Lymphoma, B-cell, Marginal zone; Stomach neoplasms
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