Abstract

The article describes the case of the primary stomach lymphoma of the stomach in a 29-year-old man. The literature data on the etiology, diagnosis and morphological characteristics of the primary lymphomas of the stomach are presented, the questions of treatment tactics, variants of cytostatic therapy schemes are touched upon. In the described clinical example, the patient’s medical history is given: from the age of 16 the chronic gastroduodenitis is diagnosed, the patient periodically took omeprazole with a positive effect, there is no evidence of infection with Hp and there is no eradication. In April 2016, he noted the deterioration of health in the form of the appearance of discomfort in the epigastric region. In April 2016, an EHDS was performed at the outpatient stage, where an antral tumor of the stomach was detected, and a biopsy of the formation was taken. Histological examination of atypical cells was not revealed, and in connection with this, in May 2016, he was hospitalized at the A.M. Burnazyan for additional examination. The article presents data of laboratory and instrumental examination, the results of EGDS, CT of thoracic and abdominal cavities, cytological, immunohistochemical, and cytogenetic studies. The patient was given three courses of cytostatic therapy. The first course of cytostatic therapy was started in June 2016, the patient transferred it satisfactorily, in the post-cytostatic period there was a leukopenia of 2,5 thousand cells/μl, against which the viral lesion of the tongue mucosa developed, and the therapy with virolex was performed with positive dynamics. The EGD control showed marked positive dynamics. The second and third courses were conducted in July-August 2016, treatment was satisfactory. In September 2016 he was discharged for dynamic observation by a hematologist. The article draws the attention of medical practitioners to the fact that, in the absence of specific clinical manifestations, the basis for the diagnosis of lymphoma in this clinical example is the timely conduct of an endoscopic study with histological, immunohistochemical and cytogenetic study of the biopsy.

Highlights

  • The EGD control showed marked positive dynamics

  • The article describes the case of the primary stomach lymphoma of the stomach in a 29-year-old man

  • In the described clinical example, the patient’s medical history is given: from the age of 16 the chronic gastroduodenitis is diagnosed, the patient periodically took omeprazole with a positive effect, there is no evidence of infection with Hp and there is no eradication

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Summary

РАЗБОР КЛИНИЧЕСКИХ СЛУЧАЕВ

В статье описан случай первичной лимфомы Беркитта желудка у 29-летнего мужчины. Приведены данные литературы об этиологии, диагностике и морфологических характеристиках первичных лимфом желудка, затронуты вопросы тактики лечения, варианты схем цитостатической терапии. На амбулаторном этапе выполнена ЭГДС, где выявлена опухоль антрального отдела желудка, взята биопсия образования. Пациенту были проведены три курса цитостатической терапии. Первый курс цитостатической терапии начат в июне 2016 г., пациент перенес его удовлетворительно, в постцитостатическом периоде отмечалась лейкопения 2,5 тыс/мкл, на фоне чего развилось вирусное поражение слизистой языка, проводилась терапия виролексом с положительной динамикой. Статья обращает внимание практикующих врачей на то, что при отсутствии специфических клинических проявлений, основой диагностики лимфомы в данном клиническом примере является своевременное проведение эндоскопического исследования с гистологическим, иммуногистохимическим и цитогенетическим исследованием биоптата. Ключевые слова: лимфома Беркитта, поражение желудка, диагностика, лечение Для цитирования: Касымова О.А., Удалов Ю.Д., Кореньков В.В., Ильченко Л.Ю.

ANALYSIS OF CLINICAL CASES
Клинический пример
UA TRIGG CHOL
Full Text
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