Gastric non-Hodgkin's lymphoma after successful treatment of Hodgkin's disease.

A patient seen at presentation for Hodgkin's disease (HD) at stage IV B was successfully treated with MOPP. In remission he developed coeliac disease, controlled by dietary measures, but 26 months after the end of chemotherapy a severe dyspeptic syndrome appeared; endoscopy and barium meal suggested the presence of a gastric tumour, which was surgically removed and showed the histological features of a non-Hodgkin's lymphoma, lympho-histiocytic type. Only moderate chemotherapy was given after the operation and the patient obtained a new complete remission which has lasted 3 years so far. It is likely that the immune depression caused by HD itself and the relevant chemotherapy may have favoured the occurrence of both coeliac disease and subsequent gastric lymphoma.