Abstract

Background: Gastric signet ring cell carcinoma could occur in few cases of primary gastric lymphoma. It is less common seen after chemotherapy of gastric diffuse large B-cell lymphoma. Herein we present a case with gastric signet ring cell carcinoma occurring within the shortest interval of chemotherapy of gastric diffuse large B-cell lymphoma.

Case presentation: A 60-year-old male patient presented with intermittent upper abdominal pain, he underwent gastroscopy and there were multiple ulcerations in the stomach and biopsy showed diffused large B-cell lymphoma (DLBCL). The patient received chemotherapy, gastroscopy follow up was done after two months, three months, six months respectively. However, gastroscopic biopsy showed gastric signet ring cell carcinoma (SRC) within 10 months interval since he received the chemotherapy.

Conclusion: Our case highlights the importance of gastroscopy follow-up after chemotherapy of gastric DLBCL in the long term. Combination with chromoendoscopy, magnified endoscopy and target biopsy is crucial. Endoscopists need to be aware of potential risk of gastric adenocarcinoma occurring with primary gastric lymphoma.

Keywords: Gastroscopy; Gastric lymphoma; Adenocarcinoma; Surveillance

Abbreviations: DLBCL: Diffuse Large B Cell Lymphoma; GA: Gastric Adenocarcinoma; PGL: Primary Gastrointestinal Lymphoma; SRC: Signet Ring Cell Carcinoma; WLI: White Light Imaging; PET-CT: Positron Emission Tomography Computed Tomography; HE: Hematoxylin and Eosin Staining