Kamakura Masato, Kodama Ryo, Makino Mutsuki, Saegusa Hisanobu, Ushimaru Hiroyasu, Kawaguchi Kenji
Department of Gastroenterology, Shinonoi General Hospital.
Department of Pathology, Shinonoi General Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2022;119(2):139-146. doi: 10.11405/nisshoshi.119.139.
An 82-year-old woman was admitted to the hospital because of tiredness and fever. She was diagnosed with acute hepatitis. Although the cause of acute hepatitis was undetermined, her health condition and liver function improved, and she was discharged. Four weeks later, she was hospitalized again because of anorexia. Laboratory data revealed worsened anemia. Endoscopy results revealed a huge ulcerative lesion in the lesser curvature of the stomach. After 4 days, she vomited blood and died of hemorrhagic shock. The autopsy revealed a nasal-type primary gastric extranodal NK/T-cell lymphoma (ENKTL). Although no lymphoma cells were found in the liver biopsy collected during the first hospitalization, lymphoma cells and lymphocytes in the liver tissue were identified during autopsy because the lymphoma had infiltrated the liver. Primary gastric ENKTL is extremely rare and poorly understood. However, the general prognosis of progressive ENKTL is poor. Early diagnosis of liver metastasis of lymphoma cells is difficult;thus, in some cases, lymphoma metastases to the liver are diagnosed during autopsy. Although further experiments are required, we report a rare case of primary gastric ENKTL.
一名82岁女性因疲劳和发热入院。她被诊断为急性肝炎。尽管急性肝炎的病因尚未确定，但她的健康状况和肝功能有所改善，随后出院。四周后，她因厌食再次住院。实验室检查结果显示贫血加重。内镜检查结果显示胃小弯处有一个巨大的溃疡性病变。4天后，她吐血并死于失血性休克。尸检显示为鼻型原发性胃结外NK/T细胞淋巴瘤（ENKTL）。尽管在首次住院期间采集的肝脏活检中未发现淋巴瘤细胞，但尸检时在肝脏组织中发现了淋巴瘤细胞和淋巴细胞，因为淋巴瘤已浸润肝脏。原发性胃ENKTL极为罕见，人们对其了解甚少。然而，进展期ENKTL的总体预后较差。淋巴瘤细胞肝转移的早期诊断困难；因此，在某些情况下，淋巴瘤肝转移是在尸检时才被诊断出来的。尽管还需要进一步的实验，但我们报告了一例罕见的原发性胃ENKTL病例。
