Paper # 001 Versión en Español English version

Adenocarcinoma of the Stomach after Therapy for Lymph Nodes Low Grade Lymphoma

Marcial Garcia-Rojo, Jesús González, Ana Morillo, Jesús Martín
Complejo Hospitalario de Ciudad Real, Ciudad Real, 13004, Spain

Complejo Hospitalario. Avda. Pío XII s/n
E-13002 Ciudad Real. Spain

[Introduction] [Materials and Methods] [Results] [Pictures] [Discussion] [Bibliography]

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Introduction


Summary

 

Second neoplasms are a common fact in the study and follow up of oncologic patients. In the case of lymphomas, a grater incidence of acute myelogenous leukemia has been described after an aggressive combined chemotherapy and radiotherapy treatment. Although these second neoplasms are commoner after Hodgkin disease, leukemias, sarcomas and carcinomas have also been described, albeit less frequently, after non Hodgkin lymphoma. The association of a gastric non Hodgkin lymphoma and gastric adenocarcinoma is well known. Very rarely the association of a lymph nodes non Hodgkin lymphoma and an adenocarcinoma of the stomach has been described.

We describe the case of an 72 years old man who presented, in may 1995, with malaise, loss weight and multiple adenopathies at both sides of the diaphragm. No hypergammaglobulinemia was observed. At that time was diagnosed of a low grade B cells non Hodgkin lymphoma, type immunocytoma. He was treated with Cyclophosphamide, Vincristine and Prednisone. After five cycles of chemotherapy the response was poor.

In January 1996 he suffered from severe gastric pain and vomiting. An gastrointestinal study showed marked alterations of the gastric mucosa, suggestive of gastric neoplasm. The histopathological study confirmed the presence of an gastric signet ring adenocarcinoma. After resection of the tumor, is was observed that 13 lymph nodes adjacent to the stomach had metastasis of the adenocarcinoma and were also affected by the non Hodgkin lymphoma described earlier. The patient is still alive with persistent lymphoma.


Marcial GarcíaDr. Marcial Garcia-Rojo M.D. Ph.D. (picture) is a staff pathologist in the Department of Pathology. Ana Morillo works as a General Practitioner in a Primary Health Care Equipment. Dr. Jesus Martin M.D. is an experienced General and Digestive Surgeon in the Surgery Department. All of them work and live at Ciudad Real, a 70.0000 people town, situated 200 kilometers from Madrid.


Ciudad Real is the Capital of a Region known as "La Mancha", were all the story of the well known novel "Don Quijote de la Mancha" develops.



Key Words: Lymphoma, Lymph Node, Adenocarcinoma, Stomach, Chemotherapy, Tumoral Collision

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