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[Temporary spontaneous remission in Ki-1 (CD30) lymphoma with gastric lesion]
S Chiyoda1, T Morikawa, O Takahara
1Department of Internal Medicine, Japanese Red Cross Ngasaki Atomic Bomb Hospital.
Insights
This case report details a 56-year-old man diagnosed with Ki-1 (CD30) lymphoma, initially misdiagnosed as gastric adenocarcinoma. The patient experienced fluctuating symptoms and lymph node involvement before a definitive diagnosis was confirmed.
Area of Science:
- Oncology
- Hematology
- Pathology
Background:
- This report focuses on a rare case of Ki-1 (CD30) lymphoma in a 56-year-old male.
- The initial presentation mimicked gastric adenocarcinoma, highlighting diagnostic challenges.
Observation:
- The patient presented with cervical lymph node swelling and was initially diagnosed with gastric adenocarcinoma.
- Biopsies revealed malignant lymphoma, necrosis, and later confirmed Ki-1 (CD30) positivity in both lymph node and gastric tissues.
- The disease course involved fluctuating lymphadenopathy and gastric lesions over approximately two years.
Findings:
- Immunohistochemical analysis confirmed the presence of Ki-1/Ber-2H markers, establishing the final diagnosis of Ki-1 lymphoma.
- The case illustrates the complex and variable presentation of this hematologic malignancy.
Implications:
- This case underscores the importance of thorough diagnostic workup, including advanced cell marker analysis, for lymphomas with unusual presentations.
- Understanding the clinical behavior of Ki-1 lymphoma is crucial for effective patient management and treatment strategies.
Abstract:
A case of 56 year-old man with Ki-1 (CD30) lymphoma is reported. He noticed cervical lymph node swelling and was admitted with temporary diagnosis of gastric adenocarcinoma in February 1986. His physical examination showed several from 1 to 4 cm size enlarged cervical and axillary lymph nodes. His first lymph node biopsy demonstrated the histological picture of malignant lymphoma. After 20 days his second lymph node biopsy demonstrated the picture of necrosis. Second gastric biopsy showed the picture of neither gastric cancer nor malignant lymphoma, in spite of his first gastric biopsy finding with adenocarcinoma that turned out to be malignant lymphoma by later reinvestigation. After word those lymph nodes disappeared and have not been palpable for about ten months. In October 1987, elevated LDH value, lymph node swelling and gastric lesion were again observed and sixth gastric biopsy demonstrated the picture of malignant lymphoma. He was treated with anti-lymphoma drugs. After his partial remission, he died of gastrointestinal bleeding in April 1988. Specimens of both first lymph node biopsy and sixth gastric biopsy were examined with cell markers for infiltrated cells and were positive for Ki-1/Ber-2H. His final diagnosis was Ki-1 lymphoma.
