A CASE OF GASTRIC MALIGNANT LYMPHOMA WITH EXTENSIVE ESOPHAGEAL INVASION

A case of malignant lymphoma of the stomach with invasion to the middle third of the esophagus is reported. A 57-year-old woman was seen at the hospital because of epigastric pain. The X-ray examination of the esophagus and the stomach revealed a tumor centering on the upper gastric body with invasion as far as the middle of the esophagus. Abdominal CT scanning showed marked thickening in the lower part of the esophagus, suggesting invasion to the esophagus. There was no swelling of lymph nodes in the mediastinum and para-aorta. Surgical procedures of total gastrectomy combined with splenectomy and subtotal esophagectomy were done through the thoracoabdominal approach, and the left side segment of the colon was interposed. The tumor was 18×14 cm in size with the esophageal invasion of 11 cm. Histological type was the diffuse and mixed type lymphoma. The tumor had serosal infiltration histologically and lymph node metastasis was not recognized (0/72). Patient has not relapsed in 16 postoperative months. If there are no distant metastases but an invasion into other organs, the patient with malignant lymphoma of the stomach can have a favorable prognosis by aggressive combined resection of surrounding organs and lymphadenectomy. Because the nutrition of these patients can be maintained in a relatively favorable state and the tumor growth is expansive differing from gastric cancers.