We think that laparoscopic surgery would be a good alternative to open surgery for the treatment of large gastric GIST bigger than 5 cm in size, however a prospective randomized controlled study of tumors larger than 5 cm is necessary. Fig. 1 Ultrasounds showed an oval and heterogeneous mass of 13��10 cm molarity calculator in the left hypochondrium. Fig. 2 Unenhanced CT image: inhomogeneous tumor mass invading the left upper abdomen with irregular calcified inclusions, approximately in the center of the mass. Isodense appearance compared with the normal liver parenchyma. Fig. 3 Contrast-enhanced CT image: inhomogeneous, extraluminal, tumor mass with irregular shape. Fig. 4 The large gastric GIST (19��10��10 cm).
The gastrointestinal tract is the predominant site of extranodal non-Hodgkin lymphomas.
Multiple lynphomatous polyposis is a type of appearance of mantle cell lymphoma. It is characterized by multiple polypoid lesions involving long gastrointestinal tracts and it accounts for only approximately 1�C2% of non-Hodgkin lymphomas. A 78 years old patient was admitted to our Department of General Surgery with rectal bleeding, abdominal pain and weight loss. Multiple lymphomatous polyposis was detected by endoscopy. Endoscopic biopsies confirmed the diagnosis of mantle cell lymphoma. The patient was transferred to the Department of Hematology for cycles of chemotherapy. Keywords: Multiple lymphomatous lymphoma, Mantle cell lymphoma, Polyposis Introduction Primary non-Hodgkin��s lymphoma (NHL) of the gastrointestinal (GI) tract is the most common extranodal NHL and accounts for 4%�C20% of all NHL (1).
Mantle cell lymphoma (MCL) includes 2.5�C7 % of all NHL (2). Multiple lymphomatous polyposis (MLP) is an uncommon disease that is regarded as the gastrointestinal form of MCL (3). Morphological and immunohistochemical studies are essential for diagnosis of MLP. In fact tumor cells, typically, express CD20 or CD5 and cyclin D1 markers in these conditions (4). Most MLP cases occur in elderly patients, usually over fifty years old, and presenting clinical events like abdominal pain, melena or hematochezia and weight loss. Any part of GI tract may be involved, but diffuse GI involvement of MCL is an uncommon situation (5). Hereby we report and discusse a case of a MLP with a diffuse gastrointestinal involvement, including stomach, ileum, colon, lombo-aortic lymph nodes and liver metastasis.
Case report A 78 years-old man presented at our Department of General Surgery with a 1 month-history of rectal bleeding, tenesmus, Carfilzomib abdominal pain and recent weight loss (7 kg by 4 months). Physical examination didn��t reveal palpable masses in abdomen. Laboratory data included the following: hemoglobin 13.1 g/dl, hematocrit 41.9%, white blood cell count 9300 / microL (neutrophils 71.1%, lymphocytes 20.3%), beta-2-microglobulin 3841 ng/mL. Other oncologic markers, i.e.