Gastric MALT lymphoma presented with primary perforation in an adolescent: a case report
Gastric MALT lymphoma presented with primary perforation in an adolescent: a case report
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DOI：
10.1186/s12887-019-1431-9
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发表时间：
2019-02-19
期刊：
影响因子：
2.4
通讯作者：
Lin, Pei-Chin
中科院分区：
文献类型：
--
作者：
Chang, Yu-Tang;Huang, Ming-Yii;Lin, Pei-Chin
胃肠道原发淋巴瘤是一种罕见的肿瘤，仅占胃、小肠或结肠恶性肿瘤的1-4%。胃是最常见的结外淋巴瘤，胃粘膜相关淋巴组织(MALT)淋巴瘤占原发胃淋巴瘤的40%。胃MALT淋巴瘤在50~60岁是发病高峰，在儿童人群中少见。胃MALT淋巴瘤的症状通常是非特异性的，而且胃MALT淋巴瘤的原发穿孔也很少见。病例介绍1例12岁女性，以缺铁性贫血为表现，发生胃穿孔。急诊行穿孔修补术，组织病理学显示胃MALT淋巴瘤浸润。先后行幽门螺杆菌根治和放射治疗。放疗后2个月达到完全缓解。据我们所知，她是文献中报道的最年轻的胃MALT淋巴瘤患者。结论缺铁性贫血是成人恶性肿瘤的常见表现。在儿童人群中，缺铁性贫血通常是由于营养不足或失血引起的。在这个病例中，我们报告一位没有胃溃疡病史的十几岁女性，她有罕见的胃肿瘤和罕见的原发穿孔。即使手术前的确切诊断存在不确定性，通过腹腔镜保胃治疗原发性穿孔的策略是成功的，并提供了良好的生活质量。
BackgroundPrimary lymphomas of the gastrointestinal tract are rare, accounting for only 1 to 4% of malignancies arising in the stomach, small intestine, or colon. The stomach is the most common extranodal site of lymphoma and gastric mucosa-associated lymphoid tissue (MALT) lymphoma accounts for 40% of primary gastric lymphoma. Gastric MALT lymphoma reaches its peak incidence between 50 to 60years of age, therefore, it is rarely encountered in pediatric population. The presenting symptoms of gastric MALT lymphoma are usually nonspecific and primary perforation of gastric MALT lymphoma is uncommon.Case presentationA 12year-old female presented with iron deficient anemia developed gastric perforation. Emergency laparoscopic repair of the perforation was performed and tissue pathology showed gastric MALT lymphoma infiltration. Helicobacter pylori eradication and radiotherapy were sequentially performed. Complete remission was achieved at two months after radiotherapy. To our best knowledge, she is the youngest patient with gastric MALT lymphoma reported in the literature.ConclusionIron deficient anemia is a common presenting manifestation of malignancies in adulthood. In pediatric population, iron deficient anemia is usually caused by nutritional deficient or blood loss. In this case report, we present a teenaged female without previous gastric ulcer history who presented with a rare gastric tumor and an uncommon primary perforation. Even if there is an uncertainty about the exact diagnosis prior to the surgery, the strategy of stomach-preserving therapy by laparoscopy for primary perforation was successful and provided a good quality of life.