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Gastric Lymphoma: Severe Gastric Outlet Obstruction Warranting Stent Placement
Jhanzeb Iftikhar1, Muhammad Zeeshan Siddique2, Muhammad Saqib2
1Department of Medical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
Abstract:
Primary gastric lymphoma is an uncommon entity accounting for <5% of primary gastric neoplasms and 10-15% of all non-Hodgkin lymphomas. It may present with nonspecific symptoms or features of gastric outlet obstruction (GOO). GOO can develop prior to or during treatment due to disease or post-treatment scarring. The obstruction can be both intrinsic or extrinsic. Endoscopic balloon dilatation and surgical gastrojejunostomy have been tried with variable success. Gastroduodenal stenting with self-expanding metal stents (SEMS) has been used lately with excellent results but mainly in the palliative management of gastric carcinoma with GOO or in benign GOO. We present a case of gastric diffuse large B cell lymphoma on RCHOP chemotherapy who developed severe GOO leading to profound metabolic alkalosis and electrolyte imbalances, ultimately warranting an enteral stent. Key Words: Primary gastric lymphoma, Gastric outlet obstruction, Diffuse large B cell lymphoma, Enteral stent.
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