[A case of primary splenic malignant lymphoma associated with gastric cancer]

The patient was an 85-year-old woman with a chief complaint of anemia and epigastralgia. She was diagnosed with type 4 gastric cancer(por) located in the upper-third of the stomach by gastrointestinal endoscopy in April 2011. Computed tomography scan revealed no distant metastases, but a tumor measuring about 4 cm in diameter was detected in the spleen. We performed total gastrectomy with D2 lymph node dissection and splenectomy in June 2011. The postoperative pathological finding of the gastric cancer was pT4aN3aM1P0CY1H0, p-Stage IV(Japanese Classification of Gastric Carcinoma, 14th Edition). Histological examination of the splenic tumor revealed a follicular-type malignant lymphoma. At present, our patient is being treated with S-1 monotherapy in the outpatient clinic and shows no signs of recurrence. However, it is important that the patient is followed-up carefully because peritoneal lavage cytology was positive and the relapse rate of follicular lymphoma is comparatively high.