title: [Gastric perforation caused by primary gastric diffuse large B cell lymphoma].
abstract: Spontaneous gastric perforation is a rare complication of gastric lymphoma that is potentially life threatening since it can progress to sepsis and multi-organ failure. Morbidity also increases due to prolonged hospitalization and delay in initiating chemotherapy. Therefore prompt diagnosis and appropriate treatment is critical to improve prognosis. A 64-year-old man presented to the emergency department with severe abdominal pain. Chest X-ray showed free air below the right diaphragm. Abdominal CT scan also demonstrated free air in the peritoneal cavity with large wall defect in the lesser curvature of gastric lower body. Therefore, the patient underwent emergency operation and primary closure was done. Pathologic specimen obtained during surgery was compatible to diffuse large B cell lymphoma. Fifteen days after primary closure, the patient received subtotal gastrectomy and chemotherapy was initiated after recovery. Patient is currently being followed-up at outpatient department without any particular complications. Herein, we report a rare case of gastric lymphoma that initially presented as peritonitis because of spontaneous gastric perforation.
authors.affiliation: Departments of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Ju Seok
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Departments of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Woo Sun
authors.initials: WS
authors.lastname: Rou
authors.affiliation: Departments of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Byung Moo
authors.initials: BM
authors.lastname: Ahn
authors.affiliation: Departments of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Hee Seok
authors.initials: HS
authors.lastname: Moon
authors.affiliation: Departments of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Sun Hyung
authors.initials: SH
authors.lastname: Kang
authors.affiliation: Departments of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Jae Kyu
authors.initials: JK
authors.lastname: Sung
authors.affiliation: Departments of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Hyun Yong
authors.initials: HY
authors.lastname: Jeong
authors.affiliation: Departments of Pathology, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Kyu-Sang
authors.initials: KS
authors.lastname: Song
mesh_terms: D015746:Abdominal Pain; D018951:Antigens, CD20 / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005743:Gastrectomy; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging; D017493:Leukocyte Common Antigens / Q000378:metabolism; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D018951:Antigens, CD20; D017493:Leukocyte Common Antigens