Z Gastroenterol 2004; 42 - 70
DOI: 10.1055/s-2004-826971

Synchronous gastrointestinal stromal tumour and mucosa-associated lymphoid tissue lymphoma of the stomach in a Helicobacter pylori negative patient – A case report

F Kovács 1, T Gyökeres 1, I Takács 2, C Padányi 3, C Fekete 3, Á Pap 1
  • 1Dept. of Gastroenterology, MÁV Hospital, Budapest
  • 2Dept. of Pathology, MÁV Hospital, Budapest
  • 32nd Dept. of Surgery, MÁV Hospital, Budapest

Introduction: Simultaneous appearance of gastric mucosa-associated lymphoid tissue lymphoma (MALT) with gastrointestinal stromal tumor (GIST) is extremely rare. Classic studies have suggested that not only the gastric cancers, but primary gastric MALT-lymphoma but also the different gastric cancers are associated with Helicobacter pylori infection.

Case: We report on a 78 year old man who was referred to our department with upper gastrointestinal bleeding. Urgent gastroscopy revealed an ulcer in the middle of the body of the stomach. The second look endoscopy revealed an umbilicated polypoid lesion proximal to the ulcer, which was treated by segmental surgical resection of the gastric wall. Histology and immunohistochemical staining of the specimen for C-Kit confirmed the diagnosis of GIST. A few weeks later the patient was readmitted because of hematemesis. Detailed histological examination of the biopsy specimens taken from the multiple ulcers found in the middle of the body of the stomach confirmed the diagnosis of MALT-lymphoma. The absence of Helicobacter pylori was supported by repeated histological examinations and urea breath test.

In summary: A possible common etiology of these two different neoplasms found in a Helicobacter pylori negative stomach is discussed on the basis of own material and review of the literature. This is the first report on a synchronous presence of GIST and MALT lymphoma in a Helicobacter pylori negative stomach.