A Case of Synchronous Double Primary Cancer of Gastric Adenocarcinoma and Diffuse Large B Cell Lymphoma

Soo Yuck Park; Chang Soo Eun; Young Sang Byun; Ji Young Yoon; Yong Cheol Jeon; Dong Soo Han; Joo Hyun Sohn; Young-Ha Oh

doi:10.4166/kjg.2011.57.2.115

Journal List > Korean J Gastroenterol > v.57(2) > 1006770

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Park, Eun, Byun, Yoon, Jeon, Han, Sohn, and Oh: A Case of Synchronous Double Primary Cancer of Gastric Adenocarcinoma and Diffuse Large B Cell Lymphoma

Case Report

Korean J Gastroenterol 2011;57(2):115-119.

Published online: 4 October 2011

DOI: https://doi.org/10.4166/kjg.2011.57.2.115

A Case of Synchronous Double Primary Cancer of Gastric Adenocarcinoma and Diffuse Large B Cell Lymphoma

Soo Yuck Park, Chang Soo Eun, Young Sang Byun, Ji Young Yoon, Yong Cheol Jeon, Dong Soo Han, Joo Hyun Sohn, Young-Ha Oh¹

Department of Internal Medicine, Hanyang University College of Medicine, Guri, Korea

¹Department of Pathology, Hanyang University College of Medicine, Guri, Korea

Correspondence to: Chang Soo Eun, Division of Gastroenterology, Department of Internal Medicine, Hanyang University Guri Hospital, 249-1, Gyomun-dong, Guri 471-701, Korea. Tel: +82-31-560-2219, Fax: +82-31-555-2998, E-mail: cseun@hanyang.ac.kr

Received 23 July 2010 Revised 23 July 2010 Accepted 5 August 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The simultaneous occurrence of primary gastric lymphoma and adenocarcinoma is rarely reported. We here report a case of synchronous double primary tumor of advanced gastric cancer and diffuse large B cell lymphoma. A 65-year-old woman underwent an esophagogastroduodenoscopy for the evaluation of abdominal discomfort of two months' duration. The endoscopic examination showed an ulcerating tumor in the gastric antrum and thickened folds in the fundus and the microscopic examination revealed an adenocarcinoma in the antrum and a diffuse large B-cell lymphoma in the fundus. She has had total gastrectomy and CHOP chemotherapy with rituximab. Since the cases of synchronous double primary gastric tumors have been increased on the recent medical advances, when a gastric tumor is detected for the endoscopic examination, an endoscopist has to make every endeavor not to miss another tumor in the stomach.

Keywords: Synchronous neoplasms, Adenocarcinoma, Lymphoma, Large B-Cell, Diffuse

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Fig. 1.

Gastroscopic findings. (A) Initial gastroscopic finding showed huge ulcerative mass on the anterior wall of antrum. (B) Gastric mucosal folds were enlarged on the posterior wall of upper body and fundus, and several irregular erosions were seen on that mucosal surface.

Fig. 2.

Abdominal CT findings. (A) Abdominal CT showed gastric antral wall thickening with 5 cm sized excavating ulcer. (B) It also showed another lobular thickening of gas-tric wall and thickened gastric folds in the cardia and fundus.

Fig. 3.

Microscopic findings and immunohistochemical stain. Histologic finding of gastric antral mass reveals moderately (A) (H&E,×2) to poorly (B) (H&E, ×100) differentiated adenocarcinoma. The lymphoid cells infiltrated in cardia and fundus have diffusely positive cytoplasmic reaction for (C) CD79a (×40) and (D) CD10 (×400).

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