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Japanese Journal of Clinical Oncology 2005 35(10):591-594; doi:10.1093/jjco/hyi164
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© 2005 Foundation for Promotion of Cancer Research

Synchronous Adenocarcinoma and Mucosa-associated Lymphoid Tissue (MALT) Lymphoma in a Single Stomach

Sun-Young Lee1, Jae J. Kim2, Jun Haeng Lee2, Young-Ho Kim2, Poong-Lyul Rhee2, Seung Woon Paik2, Jong Chul Rhee2 and Young Hyeh Ko3

1 Department of Internal Medicine, Konkuk University College of Medicine, 2 Department of Medicine and 3 Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

For reprints and all correspondence: Jae J. Kim, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Irwon-dong, Gangnam-gu, Seoul 135-710, Korea. E-mail: jjkim{at}smc.samsung.co.kr

Received May 12, 2005; accepted August 10, 2005

Background: Synchronous gastric adenocarcinoma and primary gastric mucosa-associated lymphoid tissue (MALT) lymphoma are rare, and the characteristics of these tumors are still unclear.

Methods: Histology of endoscopic and surgical specimens of 6012 gastric adenocarcinoma and 25 primary gastric MALT lymphoma cases were reviewed.

Results: Five cases of synchronous tumors were found among 25 primary gastric MALT lymphoma patients (20.0%) and among 6012 gastric adenocarcinoma patients (8.3%). Helicobacter pylori was detected only in two cases (40.0%) of these five synchronous cases. In only one case, two types of malignant cells were mingled each other as a colliding tumor. In other four cases, two pathologies coexisted separately. These two types of malignant tumors were not distinguished by endoscopic or gross findings.

Conclusions: Although gastric adenocarcinoma coexists with MALT lymphoma at a relatively high frequency, synchronous carcinoma can be misinterpreted as a multifocal separated lesion of MALT lymphoma owing to their macroscopic resemblance. Therefore, gastric MALT lymphoma patients should be carefully examined by endoscopy, and any suspicious area must be biopsied considering the possibility of coexisting adenocarcinoma. In addition, etiologies other than H. pylori should be considered in these synchronous tumors.

Key Words: gastric cancers • adenocarcinoma • lymphoma • mucosa-associated lymphoid tissue


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