Case Report
Copyright ©2009 Baishideng. All rights reserved.
World J Gastrointest Oncol. Oct 15, 2009; 1(1): 93-96
Published online Oct 15, 2009. doi: 10.4251/wjgo.v1.i1.93
Gastric amyloidoma in patient after remission of Non-Hodgkin’s Lymphoma
Charles Philip Koczka, Adam J Goodman
Charles Philip Koczka, Adam J Goodman, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY 11203, United States
Author contributions: Koczka CP wrote the manuscript; Goodman AJ provided insightful critiques.
Correspondence to: Charles Philip Koczka, MD, Clinical Assistant Instructor, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY 11203, United States. charles.koczka@downstate.edu
Telephone: +1-718-2702353 Fax: +1-718-2704488
Received: February 3, 2009
Revised: April 18, 2009
Accepted: April 25, 2009
Published online: October 15, 2009
Abstract

Amyloidosis is commonly systemic, occasionally organ-limited, and rarely a solitary localized mass. The latter, commonly referred to as tumoral amyloidosis, is described as occurring in nearly every organ/tissue. Only a few reports of gastric amyloidosis exist today. We describe a 72 year-old black male from Barbados presenting with 3 d of diffuse abdominal pain. His medical history included Non-Hodgkin’s Lymphoma diagnosed five years ago, status-post six rounds of cyclophosphamide, adriamycin, vincristine, prednisone chemotherapy, and currently was in remission. On computed tomography scan of the abdomen, thickening and calcification of the gastric wall was noted along with pneumatosis. On esophagogastroduodenoscopy, a large circumferential friable mass was seen from the gastroesophageal junction to the body. A large non-bleeding 3 cm polyp was also seen in post bulbar area of duodenum. Biopsies were stained with Congo red and gave green birefringence under polarized light, consistent with tumoral amyloidosis. Positron emission tomography scan revealed diffuse gastric mucosa uptake compatible with gastric malignancy without metastatic foci. Treatment for gastric amyloidomas has presently been one of observation or, at most, resection of the amyloid mass. It is not known if our patient required the same approach or if this warranted the re-institution of chemotherapy for Non-Hodgkin’s Lymphoma. Until more reports of tumoral amyloidosis are made known, treatment as well as prognosis remain uncertain.

Keywords: Amyloidoma, Non-Hodgkin, Lymphoma, Stomach, Duodenum