[Metachronous triple malignant lymphoma of the stomach]

A 72-year-old female who had undergone partial gastrectomy (Billroth I method) 8 years earlier because of a diagnosis of malignant carcinoma of the stomach (histopathological diagnosis: ML. Histiocytic, Diffuse--Rappaport--) visited our hospital because of dysphagia for the past three months. X-ray and fiberscopic examination revealed the same malignancy in the remnant stomach. Curative extirpation of the remnant stomach, resection of the lower esophagus and pancreatosplenectomy were performed. There were two lesions in the resected specimen. One was a large tumor of Borrmann 3 type (8 cm in diameter) at the EGJ; the other was a small IIc-like tumor (2 cm in diameter) at the surgical stump on the lessercurvature. These three metachronous malignant lymphomas returned the same pathological findings. Compared to carcinoma, malignant lymphoma of the stomach occurs more frequently in the fornix and the tendency for multiple occurrence is strong. When partial gastrectomy is performed for malignant lymphoma of the stomach, follow-up of the remnant stomach must be carried out carefully.