23692              LYMPHOMATOUS INFILTRATION OF THE STOMACH

The patient was a women aged 82.  She was first seen in the O.P.D. 4 years before her death because of painless lymphadenopathy which had been present for 6 months.  Biopsy was reported as showing chronic non-specific reactive changes only, and no treatment was given.  Two years later she was admitted with left deep vein thrombosis and a further lymph node biopsy showed early follicular lymphoma.  A year later a course of chlorambucil was given for the generalised lymphadenopathy with a good response for some months.  She was then given a second course for recurrent lymph nodal enlargement.  She finally developed bilateral hydronephrosis from ureteric obstruction and died of congestive cardiac failure, renal failure and bronchopneumonia.  At postmortem there was extensive involvement of abdominal lymph nodes and the liver.

The specimen is the stomach.  There is a rounded pale lymphomatous mass 2 cms in diameter in the fundus of the stomach on the greater curvature.  From this, infiltrated thickened rugae extend distally for some 13 cms.  Histology shows a diffuse lymphoma composed of small polygonal cells.  There are no giant cells.