Occult follicular lymphoma in a swollen regional lymph node of gastric schwannoma

Abstract Background Regional lymphadenopathy is more commonly noted in gastric schwannomas than in other gastric submucosal tumors. Most of the swollen lymph nodes associated with gastric schwannomas are non-metastatic lymphadenopathy. Case presentation A 69-year-old Japanese woman was referred to o...

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Main Authors: Shuichi Fukuda, Taichi Koyama, Tomoko Wakasa, Hitoshi Hanamoto, Tomoyuki Tsujimoto, Atsushi Gakuhara, Hideo Tomihara, Katsuya Ohta, Kotaro Kitani, Kazuhiko Hashimoto, Hajime Ishikawa, Jin-ichi Hida, Masao Yukawa, Yoshio Ohta, Masatoshi Inoue
Format: Article
Language:English
Published: Japan Surgical Society 2020-09-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-020-00996-6
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author Shuichi Fukuda
Taichi Koyama
Tomoko Wakasa
Hitoshi Hanamoto
Tomoyuki Tsujimoto
Atsushi Gakuhara
Hideo Tomihara
Katsuya Ohta
Kotaro Kitani
Kazuhiko Hashimoto
Hajime Ishikawa
Jin-ichi Hida
Masao Yukawa
Yoshio Ohta
Masatoshi Inoue
author_facet Shuichi Fukuda
Taichi Koyama
Tomoko Wakasa
Hitoshi Hanamoto
Tomoyuki Tsujimoto
Atsushi Gakuhara
Hideo Tomihara
Katsuya Ohta
Kotaro Kitani
Kazuhiko Hashimoto
Hajime Ishikawa
Jin-ichi Hida
Masao Yukawa
Yoshio Ohta
Masatoshi Inoue
author_sort Shuichi Fukuda
collection DOAJ
description Abstract Background Regional lymphadenopathy is more commonly noted in gastric schwannomas than in other gastric submucosal tumors. Most of the swollen lymph nodes associated with gastric schwannomas are non-metastatic lymphadenopathy. Case presentation A 69-year-old Japanese woman was referred to our hospital with a chief complaint of abdominal discomfort. Contrast-enhanced computed tomography (CT) of the abdomen revealed an extraluminal tumor with heterogeneous enhancement at the middle stomach on the lesser curve, accompanied with one swollen lymph node approximately 10 mm in size and several small lymph nodes in the perigastric region. These lymph nodes were flat; therefore, we considered them to be non-metastatic. The main tumor was removed via wedge resection. Soft and slightly swollen lymph nodes, which were compatible with the lymph nodes noted in the preoperative CT, were found near the main tumor in the fatty tissue at the lesser curvature of the stomach. An excisional biopsy of the largest lymph node was performed for the diagnosis. Based on pathological findings, a diagnosis of gastric schwannoma and follicular lymphoma (FL) was confirmed. The patient is doing well without recurrence of either the gastric schwannoma or FL 28 months postsurgery. Conclusions The present report detailed an extremely rare case of FL coincidentally discovered in the swollen regional lymph node of gastric schwannoma.
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spelling doaj-art-211c52eb98954766b4b8adefad3db7162025-08-20T03:15:13ZengJapan Surgical SocietySurgical Case Reports2198-77932020-09-01611610.1186/s40792-020-00996-6Occult follicular lymphoma in a swollen regional lymph node of gastric schwannomaShuichi Fukuda0Taichi Koyama1Tomoko Wakasa2Hitoshi Hanamoto3Tomoyuki Tsujimoto4Atsushi Gakuhara5Hideo Tomihara6Katsuya Ohta7Kotaro Kitani8Kazuhiko Hashimoto9Hajime Ishikawa10Jin-ichi Hida11Masao Yukawa12Yoshio Ohta13Masatoshi Inoue14Department of Gastroenterological Surgery, Kindai University Nara HospitalDepartment of Gastroenterological Surgery, Kindai University Nara HospitalDepartment of Pathology, Kindai University Nara HospitalDepartment of Hematology, Kindai University Nara HospitalDepartment of Gastroenterological Surgery, Kindai University Nara HospitalDepartment of Gastroenterological Surgery, Kindai University Nara HospitalDepartment of Gastroenterological Surgery, Kindai University Nara HospitalDepartment of Gastroenterological Surgery, Kindai University Nara HospitalDepartment of Gastroenterological Surgery, Kindai University Nara HospitalDepartment of Gastroenterological Surgery, Kindai University Nara HospitalDepartment of Gastroenterological Surgery, Kindai University Nara HospitalDepartment of Gastroenterological Surgery, Kindai University Nara HospitalDepartment of Gastroenterological Surgery, Kindai University Nara HospitalDepartment of Pathology, Kindai University Nara HospitalDepartment of Gastroenterological Surgery, Kindai University Nara HospitalAbstract Background Regional lymphadenopathy is more commonly noted in gastric schwannomas than in other gastric submucosal tumors. Most of the swollen lymph nodes associated with gastric schwannomas are non-metastatic lymphadenopathy. Case presentation A 69-year-old Japanese woman was referred to our hospital with a chief complaint of abdominal discomfort. Contrast-enhanced computed tomography (CT) of the abdomen revealed an extraluminal tumor with heterogeneous enhancement at the middle stomach on the lesser curve, accompanied with one swollen lymph node approximately 10 mm in size and several small lymph nodes in the perigastric region. These lymph nodes were flat; therefore, we considered them to be non-metastatic. The main tumor was removed via wedge resection. Soft and slightly swollen lymph nodes, which were compatible with the lymph nodes noted in the preoperative CT, were found near the main tumor in the fatty tissue at the lesser curvature of the stomach. An excisional biopsy of the largest lymph node was performed for the diagnosis. Based on pathological findings, a diagnosis of gastric schwannoma and follicular lymphoma (FL) was confirmed. The patient is doing well without recurrence of either the gastric schwannoma or FL 28 months postsurgery. Conclusions The present report detailed an extremely rare case of FL coincidentally discovered in the swollen regional lymph node of gastric schwannoma.http://link.springer.com/article/10.1186/s40792-020-00996-6Intraoperative pathological diagnosisLymphadenopathyLymphoid cuffMalignant lymphomaSubmucosal tumor
spellingShingle Shuichi Fukuda
Taichi Koyama
Tomoko Wakasa
Hitoshi Hanamoto
Tomoyuki Tsujimoto
Atsushi Gakuhara
Hideo Tomihara
Katsuya Ohta
Kotaro Kitani
Kazuhiko Hashimoto
Hajime Ishikawa
Jin-ichi Hida
Masao Yukawa
Yoshio Ohta
Masatoshi Inoue
Occult follicular lymphoma in a swollen regional lymph node of gastric schwannoma
Surgical Case Reports
Intraoperative pathological diagnosis
Lymphadenopathy
Lymphoid cuff
Malignant lymphoma
Submucosal tumor
title Occult follicular lymphoma in a swollen regional lymph node of gastric schwannoma
title_full Occult follicular lymphoma in a swollen regional lymph node of gastric schwannoma
title_fullStr Occult follicular lymphoma in a swollen regional lymph node of gastric schwannoma
title_full_unstemmed Occult follicular lymphoma in a swollen regional lymph node of gastric schwannoma
title_short Occult follicular lymphoma in a swollen regional lymph node of gastric schwannoma
title_sort occult follicular lymphoma in a swollen regional lymph node of gastric schwannoma
topic Intraoperative pathological diagnosis
Lymphadenopathy
Lymphoid cuff
Malignant lymphoma
Submucosal tumor
url http://link.springer.com/article/10.1186/s40792-020-00996-6
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