Yanagawa Naoki, Ogata Shin-Ya, Fukushima Norimasa, Maeda Kunihiko, Tamura Gen
Department of Pathology and Laboratory Medicine, Yamagata Prefectural Central Hospital, Yamagata, Japan.
Case Rep Gastroenterol. 2012 Sep;6(3):797-802. doi: 10.1159/000346465. Epub 2012 Dec 22.
We report the rare case of a 72-year-old man with double cancers (gastric adenocarcinoma and Hodgkin's lymphoma) with collision between gastric adenocarcinoma and Hodgkin's lymphoma. Abdominal computed tomography showed increased wall thickness in the fundus region of the stomach and multiple lymph node swellings in the lesser curvature, periceliac and left cardial regions. Upper gastrointestinal endoscopy showed an ulcer approximately 5 cm in diameter with a malignant appearance in the fundus region of the stomach. On histopathologic examination, two completely different tumors were recognized in the stomach. One tumor was a poorly differentiated adenocarcinoma characterized by poorly developed tubular structures associated with prominent lymphoid infiltration of the stroma. The other tumor was found to have proliferated in the wall of the stomach, with diffuse granulomatous lesions and bordering the adenocarcinoma. Large atypical lymphoid cells with prominent nucleoli and enlarged mononuclei or multinuclei were seen in the latter tumor. Hodgkin's lymphoma was also found in the swollen lesser curvature lymph nodes. As a result, gastric adenocarcinoma and metastasis of Hodgkin's lymphoma were collided in the stomach. In conclusion, this case might be helpful in exploring the occurrence mechanism of tumor collision between lymphoma and carcinoma.
我们报告了一例罕见的72岁男性患有双癌（胃腺癌和霍奇金淋巴瘤），胃腺癌与霍奇金淋巴瘤相互碰撞。腹部计算机断层扫描显示胃底部区域胃壁增厚，小弯侧、腹腔周围和贲门左侧区域有多个淋巴结肿大。上消化道内镜检查显示胃底部区域有一个直径约5 cm的溃疡，外观呈恶性。组织病理学检查发现胃内有两种完全不同的肿瘤。一种肿瘤是低分化腺癌，其特征是管状结构发育不良，伴有间质明显的淋巴样浸润。另一种肿瘤在胃壁中增殖，有弥漫性肉芽肿病变，与腺癌相邻。在后一种肿瘤中可见具有明显核仁的大的非典型淋巴样细胞以及单核或多核增大。在肿大的小弯侧淋巴结中也发现了霍奇金淋巴瘤。结果，胃腺癌与霍奇金淋巴瘤转移灶在胃内相互碰撞。总之，该病例可能有助于探索淋巴瘤与癌之间肿瘤碰撞的发生机制。
