Adult T-Cell Leukemia/Lymphoma with Gastric Lesion

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A case of adult T-cell leukemia/lymphoma with a gastric tumor is presented. The patient was a 72-year-old woman who had been admitted to our hospital because of epigastric pain. Upper gastrointestinal endoscopy disclosed polypoid region in the antrum of the stomach. Specimens taken from this region revealed malignant lymphoma. Although the patient was serologically positive for human T-cell leukemia virus type I antibody. A chest X-ray, abdominal ultrasonography, and whole body computed tomography revealed no lymphadenopathy. We diagnosed her to have primary gastric malignant lymphoma and thus performed a total gastrectomy with regional lymph node excision and a splenectomy. Both histological and immunohistochemical studies of the resected specimen showed the lymphoma to be a diffuse pleomorphic type with a T cell phenotype. A radical surgical resection could be performed. At nine months postoperatively, she was again admitted to our hospital because of abdominal pain. Both ultrasonography and computed tomography revealed lymph node swelling around the surrounding the para aorta. She was treated with systematic chemotherapy. Unfortunately, she died at one year after the operation.