PRIMARY NON-HODGKIN-LYMPHOMA OF THE GASTRIC STUMP

Patients with a history of gastroduodenal surgery for benign lesions a re at increased risk of developing cancer of the gastric stump. The ma jority of malignant tumors arising in gastric remnants are adenocarcin omas, but a few of cases of malignant lymphoma have been reported as w ell. Some recent studies have suggested that Helicobacter pylori-assoc iated gastritis may play a role in the pathogenesis of primary gastric lymphoma. We report a case of primary high grade polymorphic B-cell l ymphoma (high grade MALT lymphoma) occurring in the gastric stump of a 74-year-old man 17 years after Billroth-II gastrectomy. The non-tumor ous gastric mucosa showed features of reflux gastritis with presence o f deeply situated dense lymphoid aggregates in the lamina propria Howe ver, no micro-organisms with the morphology of Helicobacter pylori cou ld be found at the luminal surface. The literature concerning gastric stump lymphomas is reviewed.