[A case of gastric malignant lymphoma with perforation during chemotherapy]

A 54-year-old male was admitted for loss of appetite lasting for about 3 months. The patient was diagnosed as malignant lymphoma in the stomach invading directly the pancreas, spleen and transverse colon. Chemotherapy, two cycles of VEPA.M, was selected as the initial treatment. After the first cycle of chemotherapy, the patient was discharged temporarily. During the second cycle, on an ambulant basis, the patient suddenly complained of severe pain and distension in the abdomen. Through the X-ray examination of the chest, free air was demonstrated in the bilateral subphrenic spaces. The patient was diagnosed as perforation of the gastrointestinal tract. Subsequently, total gastrectomy was performed. Pathological examination revealed no malignant cells in the stomach wall. It is suggested that the perforation was caused by weakening of the stomach wall following chemotherapy.