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Mucosa‐associated lymphoid tissue lymphoma coexisting with epithelioid granulomas in the stomach of a patient with systemic sarcoidosis
Author(s) -
Fukuda Takeaki,
Sato Keiichi,
Tachikawa Shinzo,
Ohnuki Keizo,
Ohtani Hideo,
Suzuki Toshimitsu
Publication year - 1997
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.1997.tb03720.x
Subject(s) - stomach , pathology , sarcoidosis , lymphoma , medicine , caseous necrosis , epithelioid cell , biopsy , lymph , gastric lymphoma , lymphatic system , granuloma , immunohistochemistry , gastroenterology
Malignant lymphoma arising in the stomach of a 23‐year‐old Japanem man with systemic sarcoldosis is presented. The patient was followed because of systemic sarcoidosis involving the lungs, eyes, and lymph nodes. Biopsy specimens from the stomach were repeated because of recurrent eplgastraigia and multiple ulcerations. Some of the specimens revealed epithelloid granuiomas with no caseous necrosis, which confirmed gastric involvement of sarcoidosis. Three years after the initial diagnosis, biopsy specimens taken from the stomach were diagnosed as malignant lymphoma of the large cell type. The resected stomach revealed muiticentric mucosa‐associated type malignant lymphoma of low‐grade B cell type, with foci of high‐grade transformation coexisting with numerous epithelioid granulomas with no caseous necrosis. Epithelloid granulomas were observed in all the respected lymph nodes, liver, and appendix, which had been obtained at operation, whereas malignant lymphoma was limited to the stomach. Hellcobacter pylori (H. pylori ) infection was also observed in the stomach. Consequently, the present report is a rare case of coexistence of malignant lymphoma and involvement of sarcoidosis in the stomach. Both H. pylori infection and active sarcoid noduies may play a role in the development of malignant lymphoma, although the exact mechanism remains undear.