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Synchronous Primary Diffuse Large B Cell Lymphoma and Adenocarcinoma of the Stomach: a Clinical Dilemma
Author(s) -
Fabio Carboni,
Maria Grazia Diodoro,
Mario Valle
Publication year - 2020
Publication title -
indian journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 16
eISSN - 0976-6952
pISSN - 0975-7651
DOI - 10.1007/s13193-020-01119-1
Subject(s) - medicine , surgical oncology , adenocarcinoma , stomach , stage (stratigraphy) , lymphoma , radiology , gastric lymphoma , cancer , pathology , paleontology , biology
A 65-year-old Caucasian man was admitted to our department with progressive weakness, dyspepsia, and weight loss. Endoscopic biopsies revealed a gastric diffuse large B cell lymphoma. Computed tomography scan showed a locally advanced bulky gastric tumor with peritoneal involvement. Laparoscopic staging was performed and biopsies showed peritoneal localization of adenocarcinoma. A new endoscopy with multiple mapping biopsies confirmed the diagnosis of diffuse large B cell lymphoma. A multidisciplinary team evaluated the stage of both tumors and the patient started on a chemotherapy regimen with cisplatin, 5-fluorouracil, and trastuzumab (ToGA). He is currently alive with disease at 9 months after surgery. Synchronous occurrence of primary lymphoma and adenocarcinoma of the stomach is extremely rare. Symptomatology is similar and accurate diagnosis requires a combination of both morphological and immunohistochemical analyses. Treatment should be planned considering the stage of both diseases.

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