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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

84 -year-old male

Clinical Characteristics

Presented with chest pain work-up revealed atrial fibrillation and anemia with guaiac positive stools upper gi series revealed concentric narrowing of the stomach with multiple areas of ulceration endoscopy revealed nodular thickening of the antral gastric mucosa with multiple ulceration endoscopic biopsy showed malignant lymphoma the patient was started on cimetidine and metoclopramide, pending surgery cimetidine or ranitidine was continued until surgery surgery was performed after a delay of 5 weeks and consisted of subtotal gastrectomy and biopsy of a celiac ln endoscopic biopsy specimens showed a diffuse infiltrate of large atypical lymphoid cells, extensive necrosis and superficial candidiasis also were present, histologic findings were those of malignant lymphoma, diffuse, large cell gastric resection consisted of a subtotal gastrectomy measuring 17cm in length along the greater curvature two stellate ulcers, measuring 7mm and 9mm were identified along the lesser curve and a third ulcer measuring 4mm in the pylorus multiple sections from the ulcerated area showed fibrosis with mucosal atrophy and an infiltrate composed of small mature lymphocytes

Remission Characteristics

After surgery, no tumor recurrence has been noted for 10 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, metoclopramid, ranitidine subtotal gastrectomy

Non-Clinical Treatment

None reported