Tang Chung-Chih, Shih Lee-Yung, Chen Pang-Chi, Chen Tse-Ching
Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei Taiwan, ROC.
Chang Gung Med J. 2002 Feb;25(2):115-21.
Gastric adenocarcinoma developing concomitantly with a gastric lymphoma of the mucosa-associated lymphoid tissue (MALT) type is rare. Herein, we report a case with a synchronous primary gastric MALT lymphoma and an early adenocarcinoma of the stomach. A 72-year-old patient with initial presentation of weight loss was found with endoscopy to have a large tumor mass in the gastric body. Pathologic examination of biopsies revealed a low-grade MALT lymphoma for which chemotherapy with cyclophosphamide, vincristine, and prednisolone was administered. A gastric adenocarcinoma was found at a different site in the of stomach 3 months after cessation of chemotherapy when there was still residual MALT lymphoma in the stomach. The presence of double neoplasms was established preoperatively. The patient underwent a proximal gastrectomy. Infection with Helicobacter pylori (H. pylori) was detected once in the repeated endoscopic gastric biopsies. The occurrence of both gastric MALT lymphoma and gastric adenocarcinoma was reviewed and the association of H. pylori infection with both malignancies is discussed.
同时发生的胃黏膜相关淋巴组织（MALT）型淋巴瘤和胃腺癌非常罕见。在此，我们报告一例同时患有原发性胃MALT淋巴瘤和早期胃腺癌的病例。一名72岁最初表现为体重减轻的患者经内镜检查发现胃体有一个大肿瘤块。活检病理检查显示为低级别MALT淋巴瘤，给予环磷酰胺、长春新碱和泼尼松龙化疗。化疗停止3个月后，胃部仍有残留MALT淋巴瘤时，在胃的不同部位发现了胃腺癌。术前确定存在双肿瘤。患者接受了近端胃切除术。在重复的内镜胃活检中曾检测到幽门螺杆菌（H. pylori）感染。对胃MALT淋巴瘤和胃腺癌的发生情况进行了回顾，并讨论了H. pylori感染与这两种恶性肿瘤的关联。
