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Rapid progression of Epstein-Barr-virus-positive gastric diffuse large B-cell lymphoma during chemoradiotherapy: a case report

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Abstract

A 61-year-old woman was referred to our hospital with epigastralgia and appetite loss. Barium examination and upper gastrointestinal endoscopy revealed uneven erythematous mucosa with multiple elevated lesions from the gastric fornix to the upper corpus. Abdominal computed tomography showed thickening of the wall of the fornix and swelling of perigastric lymph nodes, but whole-body gallium scintigraphy and bone marrow examination did not indicate further involvement. Biopsy specimens showed diffuse infiltration of large atypical lymphoid cells in which Epstein-Barr virus (EBV) was detected by in situ hybridization. Diffuse large B-cell lymphoma (DLBCL), stage II1, was diagnosed. Combination chemotherapy [cyclophosphamide, adriamycin, vincristine, and prednisone (CHOP)], was given, and this was followed by radiotherapy. Partial remission was achieved by chemotherapy, but the disease progressed rapidly during radiotherapy. Because the reported prognosis of EBV-positive DLBCL is unfavorable, the therapeutic strategy for EBV-positive gastric DLBCL should be considered carefully.

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Authors and Affiliations

  1. Department of Medicine and Molecular Science, Hiroshima University Graduate School of Biomedical Science, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Tomonori Sumida, Yasuhiko Kitadai, Hiroshi Masuda, Kei Shinagawa, Miwako Tanaka, Michiyo Kodama, Tsuyoshi Kuroda & Kazuaki Chayama

  2. Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan

    Shinji Tanaka

  3. Department of Pathology, Hiroshima University Graduate School of Biomedical Science, Hiroshima, Japan

    Hirofumi Nakayama

  4. Health Service Center, Hiroshima University, Hiroshima, Japan

    Toru Hiyama & Masaharu Yoshihara

  5. Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan

    Tadashi Yoshino

Authors
  1. Tomonori Sumida
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  2. Yasuhiko Kitadai
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  3. Hiroshi Masuda
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  4. Kei Shinagawa
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  5. Miwako Tanaka
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  6. Michiyo Kodama
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  7. Tsuyoshi Kuroda
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  8. Toru Hiyama
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  9. Shinji Tanaka
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  10. Hirofumi Nakayama
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  11. Masaharu Yoshihara
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  12. Tadashi Yoshino
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  13. Kazuaki Chayama
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Corresponding author

Correspondence to Yasuhiko Kitadai.

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Sumida, T., Kitadai, Y., Masuda, H. et al. Rapid progression of Epstein-Barr-virus-positive gastric diffuse large B-cell lymphoma during chemoradiotherapy: a case report. Clin J Gastroenterol 1, 105–109 (2008). https://doi.org/10.1007/s12328-008-0020-5

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  • DOI: https://doi.org/10.1007/s12328-008-0020-5

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