Synchronous and metachronous primary gastric lymphoma and adenocarcinoma

Abstract

RESULTS.Two different tumors were found synchronously in 10 patients (5 with Masatoshi Fujishima, M.D. 2 independent tumors and 5 with contiguous/collision tumors) and metachronously in 2. The size of the lymphomas (mean, 7.2 cm) was larger than that of the adeno-1 Second Department of Pathology, Faculty of carcinomas (mean, 3.6 cm) (P õ 0.005). Histologically, 9 of the 12 lymphomas Medicine, Kyushu University, Fukuoka, Japan.(75%) were mucosa-associated lymphoid tissue lymphomas, and all lymphomas 2 Second Department of Internal Medicine, Facinvaded the deep portion of the submucosa or deeper. Conversely, 10 of the 12 ulty of Medicine, Kyushu University, Fukuoka, adenocarcinomas (83%) were early carcinomas. Six adenocarcinomas were intestiJapan.nal type, whereas the other 6 were diffuse type. The MIB-1 index of the adenocarci-3 First Department of Pathology, School of Mednomas (mean, 50.4%) was higher than that of the lymphomas (mean, 29.3%) (P õ icine, Fukuoka University, Fukuoka, Japan. 0.05). Helicobacter pylori (H. pylori) was documented in all 12 patients, whereasEpstein-Barr virus-encoded RNA 1 was detected in only 2. During the followup period after surgery, 6 patients died, 4 due to adenocarcinoma. The survival probability of all 12 patients appeared to be similar to that of previously reported patients with gastric adenocarcinoma alone, and was significantly worse than that of the 217 patients with gastric lymphoma alone (P õ 0.05).CONCLUSIONS. An H. pylori infection is considered to be associated with the development of these double malignancies. In many such synchronously observed cases, lymphomas may precede carcinogenesis, while the prognosis appears to be more closely associated with the adenocarcinoma than the lymphoma. G astric adenocarcinoma is one of the most common malignancies, whereas primary gastric lymphoma is relatively uncommon, oc-The authors thank Dr. Koh-ichi Ohshima and curring in only 1 -7% of all malignant neoplasms of the stomach. Dr. Akinori Iwashita, Fukuoka University, forThe occurrence of both malignant gastric lymphoma and adenocarcitheir kind cooperation, and Brian T. Quinn for noma in the same patient is very rare, and little is known regarding his critical comments.the clinicopathologic characteristics of such cases. 2-13Address for reprints: Shotaro Nakamura, M.D.,Helicobacter pylori (H. pylori) is believed to play a causative role nocarcinomas but also primary gastric lymphomas, especially those of mucosa-associated lymphoid tissue (MALT) type, are associated

Coexistence of Epstein–Barr virus-associated gastric carcinoma with malignant lymphoma: report of two cases

“…Furthermore, EBV infection in such cases is extremely rare; to our knowledge only two cases of EBV-GC coexistent with gastric lymphoma have been reported. One was lymphoepithelioma-like carcinoma with mucosa-associated lymphoid tissue (MALT) lymphoma [8], and the other was a poorly differentiated adenocarcinoma with low-grade Tcell lymphoma of pleomorphic small cell type [15]. Besides the EBV-infected cancer cells, H. pylori infection was also observed in the previously reported two cases [8,15].…”

“…Coexistence of primary gastric lymphoma and carcinoma is extremely uncommon. Nakamura et al [15] reported that its incidence accounts for only 0.098% of all examined gastric carcinomas (nine of 9,150 cases). Furthermore, EBV infection in such cases is extremely rare; to our knowledge only two cases of EBV-GC coexistent with gastric lymphoma have been reported.…”

“…One was lymphoepithelioma-like carcinoma with mucosa-associated lymphoid tissue (MALT) lymphoma [8], and the other was a poorly differentiated adenocarcinoma with low-grade Tcell lymphoma of pleomorphic small cell type [15]. Besides the EBV-infected cancer cells, H. pylori infection was also observed in the previously reported two cases [8,15]. H. pylori infection is generally considered to cause chronic active gastritis, intestinal metaplasia, ulcer, and gastric neoplasms including adenocarcinoma and malignant lymphoma, especially MALT type lymphoma [24].…”

“…Coexistence of primary carcinoma and lymphoma in the stomach is an extremely uncommon event, accounting for 0.098% of all gastric malignancies [15]. In such cases, EBV-infection is extremely rare, and to our knowledge, only two cases of gastric EBV-GC and lymphoma have been reported [8,15].…”

“…In such cases, EBV-infection is extremely rare, and to our knowledge, only two cases of gastric EBV-GC and lymphoma have been reported [8,15]. Recently, we encountered two cases of EBV-GC with malignant lymphoma.…”