Jang Hee Ryeong, Lee Kyungyul, Lim Kyu-Hyoung
Division of Hematology and Oncology, Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University College of Medicine, South Korea.
Department of Pathology, Pathology Center, Seegene Medical Foundation, Seoul 61743, South Korea.
World J Clin Cases. 2024 Dec 16;12(35):6834-6839. doi: 10.12998/wjcc.v12.i35.6834.
Gastrointestinal lymphoma typically arises in the stomach, small bowel, or colorectum and is usually a B-cell lymphoma. However, primary T-cell lymphomas originating in the stomach are particularly rare. Gastric peripheral T-cell lymphoma-not otherwise specified (PTCL-NOS) is an extremely rare subtype.
We report a 63-year-old male presenting with epigastric pain. Esophagogastroduodenoscopy revealed a large ulcerative lesion in the gastric cardia. Biopsy and immunohistochemical profiling confirmed PTCL-NOS. Imaging indicated stage II disease involving the stomach and intra-abdominal lymph nodes. The patient is planned to undergo cyclophosphamide, doxorubicin, vincristine, and prednisone or cyclophosphamide, doxorubicin, vincristine, prednisone, and etoposide chemotherapy.
This case highlights the necessity of considering PTCL-NOS in differential diagnoses of gastric lesions. Comprehensive histopathological and immunohistochemical analysis is crucial for accurate diagnosis and guiding treatment.
胃肠道淋巴瘤通常起源于胃、小肠或结肠直肠，且通常为B细胞淋巴瘤。然而，原发于胃的T细胞淋巴瘤极为罕见。胃外周T细胞淋巴瘤，非特指型（PTCL-NOS）是一种极其罕见的亚型。
我们报告一名63岁男性，表现为上腹部疼痛。食管胃十二指肠镜检查发现胃贲门处有一个大的溃疡性病变。活检及免疫组化分析确诊为PTCL-NOS。影像学检查显示疾病处于II期，累及胃和腹腔淋巴结。该患者计划接受环磷酰胺、阿霉素、长春新碱和泼尼松或环磷酰胺、阿霉素、长春新碱、泼尼松和依托泊苷化疗。
本病例强调了在胃病变鉴别诊断中考虑PTCL-NOS的必要性。全面的组织病理学和免疫组化分析对于准确诊断和指导治疗至关重要。
