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[Gastric perforation by MALT lymphoma. Case report]
José López-Zamudio1, Luis Ricardo Ramírez-González1, Julia Núñez-Márquez2
1Unidad Médica de Alta Especialidad, Departamento de Cirugía General, Hospital de Especialidades del Centro Médico Nacional de Occidente Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco, México.
Gastric perforation secondary to mucosa associated lymphoid tissue (MALT) lymphoma is a rare but fatal complication. Prompt diagnosis and treatment are crucial for improving patient outcomes in these critical cases.
Area of Science:
- Gastroenterology
- Oncology
- Surgical Pathology
Background:
- Gastric non-Hodgkin lymphoma (NHL) constitutes approximately 7% of stomach cancers and 2% of all lymphomas.
- Mucosa associated lymphoid tissue (MALT) lymphomas most commonly occur in the gastric antrum (41%) and can be multifocal (33%).
- The risk of spontaneous perforation in gastric MALT lymphoma ranges from 4% to 10%.
Observation:
- A 24-year-old male with Human Immunodeficiency Virus presented with acute abdomen and fever.
- Computed tomography revealed free fluid and gastric wall thickening.
- Laparotomy demonstrated absence of the anterior stomach wall, adhered to the liver, colon, and omentum.
Findings:
- The patient underwent a total gastrectomy with esophagostomy and jejunostomy tube placement.
- Gastric perforation secondary to MALT lymphoma is an uncommon event.
- This complication is associated with high mortality rates.
Implications:
- Gastric MALT lymphoma perforation requires a high index of suspicion for timely diagnosis and management.
- Limited data exists on this rare complication, underscoring the need for increased awareness.
- Effective treatment strategies are essential to mitigate the high mortality associated with this condition.
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