Lege Artis Medicinae

[SIMULTANEOUS PRESENCE OF GIST AND MALT-LYMPHOMA OF THE STOMACH IN A HELICOBACTER PYLORI NEGATIVE PATIENT]

KOVÁCS Ferenc1, GYÖKERES Tibor1, TAKÁCS Imre Géza2, PADÁNYI István3, FEKETE Csaba3, OROSZ Zsolt4, PAP Ákos1

OCTOBER 18, 2006

Lege Artis Medicinae - 2006;16(10)

[INTRODUCTION - The simultaneous presence of gastric mucosa-associated lymphoid tissue lymphoma (MALT) and a gastrointestinal stromal tumor (GIST) is an extremely rare finding that has not been published until now. CASE REPORT - The authors report on a 78- year-old man who was referred to their department with an emergency upper gastrointestinal bleeding. Urgent gastroscopy revealed a bleeding ulcer in the middle third of the stomach. On the follow-up endoscopy 6 weeks later, an umbilicated polypoid lesion was found proximal to the healed ulcer, which was subsequently removed by elective surgery. Histology and immunohistochemical staining of the specimen for c-Kit confirmed the diagnosis of gastrointestinal stromal tumour. A few weeks later the patient was readmitted because of haematemesis. Upon detailed histological examination of the biopsy specimens taken from the multiple superficial ulcers found near the previous lesion, MALT-lymphoma was diagnosed. The absence of Helicobacter pylori was confirmed by repeated histological examinations, serology and urea breath test. CONCLUSION - This is the first report on a patient with simultaneous presence of a gastrointestinal stromal tumour and gastric mucosaassociated lymphoid tissue lymphoma with H. pylori negativity. Several observations suggest that the development of malignant tumours of the stomach is also associated with H. pylori infection. In view of the reported case, the possibility of a common aetiology of these two neoplasms other than H. pylori infection is discussed.]

AFFILIATIONS

  1. MÁV Kórház és Központi Rendelôintézet, Gasztroenterológiai Osztály
  2. MÁV Kórház és Központi Rendelôintézet, Patológiai Osztály
  3. MÁV Kórház és Központi Rendelôintézet, II. Sz. Sebészeti Osztály
  4. Országos Onkológiai Intézet, Patológiai Osztály

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