at the posterior wall, involving the mucosa and muscularis propria of the fundus, and extending anteriorly by 60 × 25 mm ( Figure 1). The fundal lesion consisted of a diffuse lymphoid infiltrate from the mucosa to the muscularis propria. Atypical small to intermediate cells were noted on microscopy with occasional lymphoepithelial lesions and residual reactive follicular centres. An area of necrosis within the tumour was also identified. Lymphoid immunoperoxidase staining demonstrated: CD20 and bcl2: positive CD5, CD10, CD23, bcl6 and cyclin D1: negative Ki-67 proliferative index of 5% Helicobacter pylori (H. pylori) stain: negative.A diagnosis of extranodal marginal zone B cell lymphoma of MALT (Mucosa Associated-Lymphoid Tissue) type was confirmed.Post-operatively, the patient was reviewed by a hematologist who noted her to have been asymptomatic prior to the operation but for a single episode of non-specific dysphagia and upper abdominal pain. Clinical examination revealed no lymphadenopathy or hepatosplenomegaly. Lymphoma staging with computed tomography did not show clear evidence of local spread or distal lymphadenopathy. Full blood panel was within normal limits. Peripheral blood smear did not show any evidence of lymphoproliferative disorders. Post-operative urea breath testing for H. pylori was negative. Following multidisciplinary evaluation, she was placed onto a twice yearly endoscopic surveillance program, of which the two most recent surveillance results demon- AbstractOverweight and Obesity have been associated with an increased risk of developing a variety of gastrointestinal cancers [1]. The increasing implementation of bariatric surgery to manage overweight and obesity would likely increase the incidental diagnosis of malignancies in patients who were previously asymptomatic or had nonspecific gastrointestinal symptoms. We present the case of a MALT gastric lymphoma incidentally diagnosed on histopathology following laparoscopic sleeve resection for obesity. KeywordsGastrectomy, Bariatric surgery, Obesity, Lymphoma, Gastrointestinal tumour CASE REPORT Case ReportA 59-year-old female underwent standard laparoscopic gastric sleeve resection following failure of diet and medical management for obesity (weight, 121.4 kg; BMI, 45 kg/m 2 ). Comorbidities included hypertension, hyper triglyceridaemia and insulin resistance. Routine preoperative workup including upper gastrointestinal ultrasound, and barium swallow were unremarkable.Following routine 5 port optical entry, the greater curvature vessels were divided. The sleeve resection was performed using an Endo GIA Tristapler (Medtronic, Minneapolis). The staple line was reinforced with seamguard and imbricated proximally with 3.0 Prolene sutures. There were no intra-operative complications. Macroscopic evaluation of the resected gastric specimen revealed an elevated mass measuring 180 × 30 mm
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