Yonsei Med J.  2007 Dec;48(6):1061-1065. 10.3349/ymj.2007.48.6.1061.

Synchronous Adenocarcinoma and Mantle Cell Lymphoma of the Stomach

• Kim YI
• Koo MY

• KMID: 1786227
• DOI: http://doi.org/10.3349/ymj.2007.48.6.1061

Abstract

Synchronous occurrence of mantle cell lymphoma (MCL) and gastric cancer in the same patient has not yet been reported in the English literature. MCL comprises 2.5-7% of non-Hodgkin's lymphomas and is characterized by a poor prognosis with a median survival probability of 3-4 years in most series. A 62-year-old man was referred to our hospital for evaluation of an abnormal gastric lesion. The endoscopic finding was compatible with type IIc early gastric cancer (EGC) in the middle third of the stomach, and a biopsy of the lesion proved to be carcinoma. Radical total gastrectomy with splenectomy and Roux-en-Y esophagojejunostomy were performed. The resected specimen revealed two grossly separated lesions. Postoperative histological examination reported both adenocarcinoma and MCL. Immunohistochemical staining showed positivity for CD5, CD20, and cyclin D1 in the infiltrated lymphoid cells. MCL is an aggressive non-Hodgkin's lymphoma, and the current treatment approach is still unsatisfactory. Further advancements in the understanding of the synchronous occurrence of both diseases, and more efforts on investigations of treatment are needed.

Keyword

Synchronous; adenocarcinoma; mantle cell lymphoma

MeSH Terms

Adenocarcinoma/complications/metabolism/*pathology
Antigens, CD20/analysis
Antigens, CD5/analysis
Cyclin D1/analysis
Humans
Immunohistochemistry
Lymphoma, Mantle-Cell/complications/metabolism/*pathology
Male
Middle Aged
Stomach/chemistry/*pathology
Stomach Neoplasms/complications/metabolism/*pathology

Figure

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  Fig. 1 Endoscopic images of the stomach showing two mucosal abnormalities on the lesser and greater curvatures.

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  Fig. 2 Gross findings of the resected stomach and its histological mapping.

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  Fig. 3 The stomach shows well differentiated adenocarcinoma at the superficial portion of the mucosa (× 40, Hematoxylin & Eosin (H&E) stain).

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  Fig. 4 Multiple, round lymphoid aggregates are noted in the mucosa and submucosa (× 10, H&E stain).

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  Fig. 5 The lymphocytes are small and monotonous (H&E, × 200), which are positive for CD20, CD5, and cyclin-D1 (× 400). These findings are consistent with the diagnosis of mantle cell lymphoma.

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