Case report: Diffuse large B-cell lymphoma with gastric infiltration

DLBCL is the most common histologic subtype of the NHLs accounting for about 40% of all NHL. Stage IV or disseminated disease is observed in approximately 40% of patients and is usually characterized by extranodal extramedullary infiltration. Sites of extra nodal involvement in DLBCL can include the stomach/gastrointestinal system among others.

The team led by Sergio Zepeda-Gómez from Mexico reportd a patient with a stage IV DLBCL infiltrating the stomach diagnosed at endoscopic examination and with an excellent response after 6 cycles of chemotherapy. This will be published on July 21, 2008 of the World Journal of Gastroenterology.

The patient had a 6-moth history of lumbar and left upper quadrant pain with intermittent episodes of melena. A computer tomograghy (CT) scan showed mural thickening of the gastric antrum. At endoscopic examination, multiple gastric ulcers were found. The lesions had elevated margins without active bleeding. Definite diagnosis could be made by endoscopic biopsies. The patient had a good response after chemotherapy and this response correlated well with a further endoscopic follow-up. A follow-up endoscopic examination could be considered to evaluate a good response to chemotherapy in patients with DLBCL with secondary gastric dissemination.

This report describes the endoscopic characteristics of gastric infiltration of this specific type of neoplasia and could help endoscopists to suspect or identify this entity by this diagnostic method.

Reference: Zepeda-Gómez S, Camacho J, Oviedo-Cardenás E, Lome-Maldonado C. Gastric infiltration of diffuse large B-cell lymphoma: Endoscopic diagnosis and improvement of lesions after chemotherapy. World J Gastroenterol 2008;14(27): 4407-4409
http://www.wjgnet.com/1007-9327/14/4407.asp

Correspondence to: Sergio Zepeda-Gómez, Department of Gastrointestinal Endoscopy, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga 15, Tlalpan 14000, Mexico City, Mexico. sergiozepeda@medscape.com
Telephone: +52-5-54870900 Fax: +52-5-556522391

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

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