DLBCL is the most common histologic subtype of the NHLs accounting for about 40% of all NHL. Stage IV or disseminated disease is observed in approximately 40% of patients and is usually characterized by extranodal extramedullary infiltration. Sites of extra nodal involvement in DLBCL can include the stomach/gastrointestinal system among others.
The team led by Sergio Zepeda-Gómez from Mexico reportd a patient with a stage IV DLBCL infiltrating the stomach diagnosed at endoscopic examination and with an excellent response after 6 cycles of chemotherapy. This will be published on July 21, 2008 of the World Journal of Gastroenterology.
The patient had a 6-moth history of lumbar and left upper quadrant pain with intermittent episodes of melena. A computer tomograghy (CT) scan showed mural thickening of the gastric antrum. At endoscopic examination, multiple gastric ulcers were found. The lesions had elevated margins without active bleeding. Definite diagnosis could be made by endoscopic biopsies. The patient had a good response after chemotherapy and this response correlated well with a further endoscopic follow-up. A follow-up endoscopic examination could be considered to evaluate a good response to chemotherapy in patients with DLBCL with secondary gastric dissemination.
This report describes the endoscopic characteristics of gastric infiltration of this specific type of neoplasia and could help endoscopists to suspect or identify this entity by this diagnostic method.