Sakai Takehiro, Ogura Yuta, Narita Junichi, Suto Takemichi, Kimura Daisuke, Ainai Susumu, Fujita Hajime, Kamada Mitsuru
The Department of Surgery, Aomori Rosai Hospital, 1 Minamigaoka, Shirogane-cho, Hachinohe 031-8551, Japan.
Gastric Cancer. 2003;6(3):191-6. doi: 10.1007/s10120-003-0241-8.
The simultaneous association of gastric carcinoma with gastric lymphoma is a rare event. Recent studies have suggested that not only gastric cancer but also primary gastric lymphomas, especially those of mucosa-associated lymphoid tissue (MALT) type, are associated with Helicobacter pylori infection. We report on a 51-year-old woman who was referred to our hospital for the evaluation of abnormal shadows revealed by an upper gastrointestinal radiography series. Endoscopy of the upper gastrointestinal tract revealed early cancer in the middle body of the stomach. Biopsy of the lesion subsequently proved it to be a signet-ring cell carcinoma. Total gastrectomy was performed, under a diagnosis of early gastric carcinoma. The resected specimen revealed two grossly separate lesions. Histological examination confirmed that the gastric body lesion was compatible with early moderately differentiated tubular adenocarcinoma of type 0-IIc, while the lesion of the fundus corresponded to MALT lymphoma. H. pylori was detected, and chronic gastritis was also present in the resected gastric specimen. H. pylori infection may have played a major role in the development of both the MALT lymphoma and the adenocarcinoma of the stomach in this patient.
胃癌与胃淋巴瘤同时存在是一种罕见的情况。最近的研究表明，不仅胃癌，而且原发性胃淋巴瘤，尤其是黏膜相关淋巴组织（MALT）型淋巴瘤，都与幽门螺杆菌感染有关。我们报告一例51岁女性，因上消化道造影系列检查发现异常阴影而转诊至我院。上消化道内镜检查显示胃体中部有早期癌。随后对病变进行活检，证实为印戒细胞癌。在早期胃癌的诊断下进行了全胃切除术。切除标本显示有两个明显分开的病变。组织学检查证实胃体病变符合0-IIc型早期中度分化管状腺癌，而胃底部病变为MALT淋巴瘤。检测到幽门螺杆菌，切除的胃标本中也存在慢性胃炎。幽门螺杆菌感染可能在该患者的MALT淋巴瘤和胃腺癌的发生中起了主要作用。
