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Spontaneous Regression Of Primary Malignant Lymphoma Of The Stomach In Two Nontreated Japanese

Shigematsu et al., 1989Lymphoma

Shigematsu, A., Iida, M., Lien, G. S., Imamura, T., Okada, M., Fuchigami, T., Fujishima, M., Itoh, H., & Iwashita, A. (1989). spontaneous regression of primary malignant lymphoma of the stomach in two nontreated Japanese. Journal of clinical gastroenterology, 11(5), 511–517. https://doi.org/10.1097/00004836-198910000-00006

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Abstract

Two patients with primary malignant lymphoma underwent spontaneous regression. One was a 40-year-old woman with a large ulcerating tumor on the greater curvature of the gastric antrum. This tumor shrank spontaneously, leaving only a small shallow ulcer. The resected specimen showed a minute focus of malignant lymphoma in the ulcer base. The other was a 73-year-old man who had a tumor with central ulceration on the posterior wall of the gastric antrum. Endoscopic biopsy revealed a malignant lymphoma. This tumor disappeared 60 days later. The patient refused surgery and remains well with no evidence of recurrent disease at this writing, 44 months later. Although there have been several case reports of spontaneous regression, partial or complete, of gastric malignant lymphoma, our cases seem to be the ones best proven.

Case Details

Disease Location

Pyloric antrum

Personal Characteristics

40 -year-old female japanese past history of diabetes insipidus that had been well controlled by a nasal drip of ddavp

Clinical Characteristics

In march 1983, she complained of epigastric hunger pain barium meal demonstrated a large hemispherical tumor with a smooth mucosal surface on the greater curvature of the pyloric antrum endoscopy revealed an elevated lesion with a shallow saucer-like ulceration and a smooth mucosal surface biopsy findings led to the diagnosis of malignant lymphoma endoscopic biopsy specimen was composed of diffuse infiltration of lymphoma cells, which were positive for ln-2 histologic diagnosis of malignant lymphoma, large cell type was made lab data were positive for a fecal occult blood and positive hepatitis b surface antigen the next barium meal and gastroscopy revaluationed essentially the same feature as the initial exam CT, lymphangiography, ga67 scanning and ultrasound showed that the lesion was confined to the stomach and elective surgery was considered pathologic exam of the resected specimen showed a small shallow ulcer on the greater curvature of pyloric antrum microscopically, a minute focus of malignant lymphoma 2mm in diameter was found in the granulation tissue of the ulcer base the tumor cells revealed the same features as those in the initial biopsy specimen

Remission Characteristics

40 days after the initial exam, a remarkable regression of the tumor, with no chemo or radiotherapy was observed on gastroscopy radiograph exam revaluationed a further decrease of the tumor, leaving a small ulcer with a slightly elevated surrounding margin, mimicking a benign peptic ulcer in the healing stage. Despite a remarkable diminution in the tumor size, surgical resection was performed 65 days after the initial exam the perigastric lymph nodes were free of tumor involvement the patient remains well with no evidence of recurrence 5 years and 9 months later

Treatment & Mechanisms

Proposed Remission Mechanisms

No major mechanism proposed

Clinical Treatment

Nasal drip of ddavp for diabetes surgical resection

Non-Clinical Treatment

None reported