Pulmonary metastatic spread of an extra-nodal high malignant B-cell non-Hodgkin's lymphoma of the bulbus duodeni and the pylorus of the stomach

We report a 71-year-old female patient with repeated vomitus, meteorism, ep igastric pain and reflux for more than four month. She had a palpable mass in the upper abdomen and lost 7 kg of weight during the last four months. Chest X-ray showed two masses, 2 cm and 3 cm in diameter, in the left and r ight lower lung. A stenosing polypoid mucosal swelling in the antrum and th e duodenal bulb. The pulmonal masses were biopsied unter CT-guidance. Biops y proved a high malignant B-cell non-Hodgkin's lymphoma of the stomach. The masses in the lung were identified as metastases of the gastrointestinal l ymphoma In conclusion on this tumor was an extranodal non-Hodgkin's lymphom a stadium BE IV according to Musshoff. A CHOP-chemotherapy was initiated. R estaging after three cycles of CHOP rivealed a complete remission. Primary gastrointestinal non-Hodgkin's lymphomas are relativly rare neoplas ms of the abdomen. Unusual and interesting in this case ist the metastatic pattern involving the lung periphery without local lymphnode metastases.