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Spontaneous Regression Of Gastric Lymphoma

Strauchen et al., 1987Lymphoma

Strauchen, J. A., Moran, C., Goldsmith, M., & Greenberg, M. (1987). spontaneous regression of gastric lymphoma. Cancer, 60(8), 1872–1875. https://doi.org/10.1002/1097-0142(19871015)60:8<1872::aid-cncr2820600833>3.0.co;2-6

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Abstract

Two cases of spontaneous regression of histologically diagnosed large cell lymphoma of the stomach are reported. Regressions occurred after nonspecific therapy including the H-2 antagonist cimetidine and were documented surgically. Spontaneous regression of intermediate and high-grade non-Hodgkin's lymphoma is distinctly uncommon. The possible role of cimetidine in these cases is discussed.

Case Details

Disease Location

Gi

Personal Characteristics

73 -year-old male

Clinical Characteristics

Presented with a 3.5 months history of epigastric discomfort and 1.4-1.8kg weight loss. Upper gi endoscopy demonstrated a large irregular antral ulcer with thickened gastric folds endoscopic biopsy showed malignant lymphoma abdominal CT showed changes consistent with lymphomatous infiltration of the stomach the patient was started on cimetidine and antacids which were continued until surgery. The surgery was delayed 14 weeks. An upper gi series performed 3 weeks before surgery demonstrated persistent antral ulceration at surgery, an antral ulcer was found, a partial gastrectomy and liver biopsy was performed endoscopic biopsy specimens showed a diffuse infiltrate of large atypical lymphoid cells. Focally, necrosis and ulceration were present, histologic findings were those of malignant lymphoma, diffuse, large cell the gastric resection consisted of a subtotal gastrectomy measuring 15cm in length along the greater curvature with a single smooth margined ulceration in the antral region, microscopic exam revealed a mucosal infiltrate of small, mature lymphocytes with germinal centers

Remission Characteristics

After surgery, no tumor recurrence has been noted for 16 months, no further therapy was given

Treatment & Mechanisms

Proposed Remission Mechanisms

Regression occurred following h-2 anatgonist therapy perhaps an immunomodulatory role, enhancement of NK cell activity

Clinical Treatment

Cimetidine and antacids subtotal gastrectomy

Non-Clinical Treatment

None reported