A Case of Adult Gastric Burkitt's Lymphoma with Long-term Survival

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  • NARAHARA Katsunori
    Department of Surgery, Atami Tokoro Memorial Hospital Department of Gastroenterological and Pediatric Surgery, Tokyo Medical University
  • ABE Tomomi
    Department of Surgery, Atami Tokoro Memorial Hospital
  • KATSUMATA Kenji
    Department of Gastroenterological and Pediatric Surgery, Tokyo Medical University
  • CHINEN Katsuya
    Department of Pathology, Nerima General Hospital
  • KASUYA Kazuhiko
    Department of Gastroenterological and Pediatric Surgery, Tokyo Medical University
  • TSUCHIDA Akihiko
    Department of Gastroenterological and Pediatric Surgery, Tokyo Medical University

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Other Title
  • 長期生存している成人胃Burkittリンパ腫の1例
  • 症例 長期生存している成人胃Burkittリンパ腫の1例
  • ショウレイ チョウキ セイゾン シテ イル セイジン イ Burkitt リンパシュ ノ 1レイ

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Abstract

A 35-year-old man visited the hospital with a chief complaint of discomfort while eating. Upper gastrointestinal endoscopy showed an ulcer without an accompanying mound ; no tumor cells were observed from biopsy. Computed tomography (CT) showed a 12-cm large tumor, and ultrasonic biopsy was performed to reach a definitive diagnosis. Tumor enlargement was found to have caused compression symptoms and small intestine invagination, requiring emergency surgery. The primary lesion could not be resected ; the invaginated part of the small intestine was excised, and enterostomy was performed. Based on a diagnosis of malignant lymphoma, R-CHOP chemotherapy was implemented from postoperative day 3. After febrile neutropenia was observed, six courses were administered with a 20% dosage reduction, and abdominal CT showed that the tumor had disappeared. As of 4 years since onset, the patient is now an outpatient visitor in complete remission. Twenty-one cases of adult gastric Burkitt's lymphoma have been reported from Japan, but the prognosis has been poor, with only four patients reported as surviving ≥ 1 year. Early chemotherapy is recommended for malignant lymphoma, but surgery may also often be preferred for tumor lysis syndrome, perforation, or invagination. Emergency surgery was performed prior to definitive diagnosis in the present case, but chemotherapy performed in the early stages after surgery is believed to have yielded long-term survival.

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