A Case of Multiple Gastric Cancers and Diffuse Large B Cell Lymphoma

Abstract

A 75-year-old man with epigastric discomfort and weight loss was referred to our hospital and diagnosed with gastric cancer (GC) and gastric malignant lymphoma. Upper GI endoscopy showed a protruding lesion at the anterior wall of the lesser curvature near the gastric angle and an ulcerative lesion at the lesser curvature of the gastric antrum. Both lesions were diagnosed as GC. In addition, a large ulcerative lesion extending from the upper to lower gastric body near the greater curvature was diagnosed as B cell lymphoma. Cervical, thoracic, and abdominal CT showed wall thickening from the gastric body to the antrum, as well as partially indistinct margins with the transverse colon. Lymph nodes along the lesser curvature and near the right gastroepiploic artery were enlarged, and ascites was present. The diagnosis was multiple GCs and gastric malignant lymphoma, and a total gastrectomy was performed. Histopathology showed well-differentiated adenocarcinoma at two sites (pStage ⅠA, pStage ⅠB) and diffuse large B cell lymphoma (Lugano classification : Stage IIE, transverse colon invasion, ascites cytology positive). This very rare case of multiple GCs together with gastric malignant lymphoma is reported along with a discussion of the relevant literature.