| Abstract: | Gastric adenocarcinoma is one of the most common malignancies, whereas primary gastric lymphoma is relatively uncommon. The synchronous occurrence of both gastric adenocarcinoma and malignant gastric lymphoma in the same patient is extremely rare. It is still controversial about their etiology. Recent studies have suggested that not only gastric cancer but also primary gastric lymphomas, especially those of MALT type, are associated with Helicobacter pylori infection. We report on a 48-year old male who was referred to our hospital for complaining his epigastric pain of three months duration. Endoscopic examination revealed an elevated lesion located at pylorus, and the biopsy demonstrated a moderate differentiated adenocarcinoma with superficial lamina muscularis invasion. Thus, the patient underwent total gastrectomy, and the resected specimen revealed the presence of both adenocarcinoma and MALT lymphoma. Immunohistochemical staining showed positivity for LCA and CD20 in the infiltrated lymphoid cells. However, the lesion with lymphoma was focal and smaller than that of adenocarcinoma in size, which was different from that most of the adenocarcinoma were smaller and penetrated less than coexisting MALT lymphoma reported in literature. It seemed to suggest that two lesions were primely separate, but they integrated into a lesion for a long time. |
