A 71-year-old man was referred to our hospital because of a gastric submucosal
tumor.
Gastrointestinal stromal tumor (GIST)was diagnosed in the antrum of the stomach and local resection was undergone. At this time, upper gastrointestinal endoscopy found the gastric submucosal
tumor with a size of about 5 mm on the posterior wall of the fundus, but it was followed up. The lesion had grown to a size of about 10 mm by endoscopy 2 years later, and a biopsy was performed. Gastric mucosa associated lymphoid tissue(
MALT)lymphoma was diagnosed by pathological examination, and Helicobacter pylori eradication
therapy was performed. Endoscopy
after treatment further increased the size of the lesion to about 20 mm, and ulceration was also observed. A biopsy was performed again, and a diagnosis of poorly differentiated
adenocarcinoma was made, and laparoscopic proximal
gastrectomy was undergone. It was the diagnosis of gastric
carcinoma with lymphoid stroma(GCLS), pT3N0M0, pStage ⅡA in the postoperative pathological examination. GCLS is a
rare disease with a frequency of about 1 to 4% of all
gastric cancers, and preoperative diagnosis is difficult. From the morphology and histology, the differential diagnosis from submucosal
tumors and
lymphomas becomes problems.