[Lymphomatoid gastropathy: one case report and literatures review]

Zhonghua Xue Ye Xue Za Zhi. 2018 Nov 14;39(11):937-941. doi: 10.3760/cma.j.issn.0253-2727.2018.11.013.
[Article in Chinese]

Abstract

Objective: To report the first case of lymphomatoid gastropathy in China, and to demonstrate the clinical characteristics, diagnostic approach, treatment and prognosis in this kind of patients. Methods: One patient was diagnosed as lymphomatoid gastropathy at Peking Union Medical College Hospital, and her clinical characteristics, lab data, treatment and follow-up outcomes were reviewed. Results: A case of a 51-year-old female was presented, who underwent esophagogastroduodenoscopy (EGD) due to slight epigastric discomfort. EGD revealed multiple ulcers and erosions. Biopsies showed atypical lymphocytes infiltration with CD3(+), CD56(+), CD20(-), CD8(-), TIA(+), Granzyme B(-) and Ki-67 (75%). Epstein-Barr virus-encoded RNA in situ hybridization was negative. Four months later, repeated EGD examination showed regression of the lesions without specific treatment. Conclusion: Lymphomatoid gastropathy was a unique disease entity mimicking NK/T-cell lymphomas in pathology, with the quite different profile of treatment and prognosis. It's important to consider this issue during the differential diagnosis to avoid any excessive treatment.

目的: 报道国内首例NK细胞淋巴瘤样胃病(lymphomatoid gastropathy),阐述其临床特征、诊疗方法、治疗选择及转归。 方法: 收集并分析北京协和医院诊断的一例NK细胞淋巴瘤样胃病患者的临床表现、实验室检查、治疗及转归情况。 结果: 患者为51岁女性,因上腹不适行胃镜检查发现胃内多发溃疡,病理发现黏膜内异型淋巴细胞浸润,免疫组化:CD3(+)、CD56(+)、CD20(-)、CD8(-)、TIA(+)、Granzyme B(-)、Ki-67(75%)。原位杂交:EBER(-)。诊断为NK细胞淋巴瘤样胃病,未行放化疗,密切随访。4个月后多次复查胃镜发现溃疡自发愈合。 结论: NK细胞淋巴瘤样胃病作为一种独立的疾病类型,虽然病理表现与胃肠道NK/T细胞淋巴瘤相似,但临床表现、预后完全不同。对于有这种病理改变的患者,需仔细评估其临床表现、胃镜特点,避免过度治疗。.

Keywords: EBER; Gut; Lymphomatoid gastropathy; NK/T-cell lymphoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Biopsy
  • China
  • Female
  • Humans
  • Immunophenotyping
  • In Situ Hybridization
  • Lymphatic Diseases*
  • Lymphoma, T-Cell, Peripheral
  • Middle Aged
  • Stomach Diseases