[Secondary high-grade MALT lymphoma of the stomach in a 69-year-old patient with gastrocolic fistula].
A 69-year-old man was referred to our department with an exorbitant foetor ex ore, dysphagia and dyspepsia. Upper endoscopy had been performed prior by an outpatient gastroenterologist and the patient had received an eradication therapy for a Helicobacter pylori-induced gastritis. At admission upper endoscopy showed a gastric ulcer which drained a stinking fluid. Endosonography, computed tomography and an upper gastrointestinal series with water soluble media revealed a gastrocolic fistula. Multiple biopsies showed a low-grade gastric MALT lymphoma. Therefore, a surgical reconstruction with Roux-en-Y esophagojejunostomy and transverso-descendostomy was performed. The histology of the completely removed stomach revealed a high-grade Non Hodgkin Lymphoma (NHL) with parts of a low-grade NHL. 3 weeks after surgery chemotherapy was started with the CHOP-regime which was well-tolerated by the patient.
Kirsch
C
C
Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden.
Breidert
M
M
Nagel
M
M
Kessler
U
U
Kittner
T
T
Gaertner
H J
HJ
Ehninger
G
G
D000368:Aged; D003108:Colonic Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005743:Gastrectomy; D005747:Gastric Fistula / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005753:Gastric Mucosa / Q000473:pathology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016480:Helicobacter pylori; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D008297:Male; D010439:Peptic Ulcer Perforation / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013276:Stomach Ulcer / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed
Sekundär hoch malignes MALT-Lymphom des Magens bei einem 69-jährigen Patienten mit gastrokolischer Fistel.