Unconvincing Diagnosis of a Rare Subtype of Primary Gastric Lymphoma with Incongruent Endoscopic Presentation: A Case of Gastric Schwannoma.
10.4166/kjg.2013.62.6.359
- Author:
Seung Soo LEE
1
;
In Ho KIM
Author Information
1. Department of Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.
- Publication Type:Case Reports
- Keywords:
Lymphoma, B-cell, marginal zone;
Neurilemmoma;
Stomach neoplasms
- MeSH:
Antigens, CD20/metabolism;
Antigens, CD5/metabolism;
Diagnosis, Differential;
Gastric Mucosa/metabolism/pathology;
Gastroscopy;
Humans;
Male;
Middle Aged;
Neurilemmoma/*diagnosis/pathology/surgery;
Stomach Neoplasms/*diagnosis/pathology/surgery;
Tomography, X-Ray Computed
- From:The Korean Journal of Gastroenterology
2013;62(6):359-364
- CountryRepublic of Korea
- Language:English
-
Abstract:
Primary gastric lymphoma is a rare gastric malignancy. Its diagnostic process is complex. Clinician may find initial diagnosis of primary gastric lymphoma unreliable, especially when it indicates the rarest subtype of gastric lymphoma, while its initial endoscopic presentation fails to raise the slightest suspicion of primary gastric lymphoma. A 53-year-old Korean man was diagnosed, by endoscopic examination, with a round submucosal tumor of the stomach. Deep endoscopic biopsy, however, confirmed CD5 positive gastric lymphoma. Surgical treatment was performed for diagnosis and treatment. Postoperative histological examination confirmed gastric schwannoma. Gastric schwannoma is a spindle cell tumor, characterized by a peripheral cuff-like lymphocytic infiltration. Deep endoscopic biopsy may have been misdirected to the peripheral lymphoid cuff, failing to acquire spindle cells. The literature has been reviewed, and options for diagnostic accuracy have been suggested.
