Korean J Gastroenterol.  2016 Jul;68(1):40-44. 10.4166/kjg.2016.68.1.40.

A Case of Gastro-Gastric Intussusception Secondary to Primary Gastric Lymphoma

• Jo HH
• Kang SM
• Kim SH
• Ra M
• Park BK
• Kwon JG
• Kim EY
• Jung JT
• Kim HG
• Ryoo HM
• Kang UR

• KMID: 2344491
• DOI: http://doi.org/10.4166/kjg.2016.68.1.40

Abstract

In adults, most intussusceptions develop from a lesion, usually a benign or malignant neoplasm, and can occur at any site in the gastrointestinal tract. Intussusception in the proximal gastrointestinal tract is uncommon, and gastro-gastric intussusception is extremely rare. We present a case of gastro-gastric intussusception secondary to a primary gastric lymphoma. An 82-year-old female patient presented with acute onset chest pain and vomiting. Abdominal CT revealed a gastro-gastric intussusception. We performed upper gastrointestinal endoscopy, revealing a large gastric mass invaginated into the gastric lumen and distorting the distal stomach. Uncomplicated gastric reposition was achieved with endoscopy of the distal stomach. Histological evaluation of the gastric mass revealed a diffuse large B cell lymphoma that was treated with chemotherapy.

Keyword

Intussusception; Stomach; Endoscopy; Primary gastric lymphoma

MeSH Terms

Adult
Aged, 80 and over
Chest Pain
Drug Therapy
Endoscopy
Endoscopy, Gastrointestinal
Female
Gastrointestinal Tract
Humans
Intussusception*
Lymphoma*
Lymphoma, B-Cell
Stomach
Tomography, X-Ray Computed
Vomiting

Figure

• 

  Fig. 1. Initial abdominal CT findings. Axial (A) and coronary (B) view of abdominal CT shows a 3.8 cm sized mass arising from the proximal body. The mass is telescoping into the antrum (arrows).

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  Fig. 2. Esophagogastroduodenoscopic findings. (A) There is deformity and stenosis in the proximal body of stomach. (B) When the upper gastrointestinal endoscope passes through the stenotic lesion, congestive mucosa with edema is identified in stenotic areas. (C) Post-reduction view shows diffuse congestive mucosa with edema at the greater curvature of gastric body. (D) Post-reduction view shows about 4×4 cm sized polypoid mass with ulcer at the great curvature of proximal body.

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  Fig. 3. Three-dimensional abdominal CT findings. Axial (A) and coronal (B) view of abdominal CT shows 5.2×2.2 cm sized mural mass at great curvature of proximal body of stomach (arrows). There is no evidence of lymph node metastasis.

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  Fig. 4. Microscopic findings of mass. (A) Atypical large lymphocytes infiltration (H&E, ×400). (B) Immunohistochemical staining is positive for CD20 (×200).

Reference

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