Non-Hodgkin's lymphoma of the gastric stump developing 9 years after a distal gastrectomy for a peptic ulcer: a case report and review of the literature.

We report herein the case of a 65-year-old man who developed non-Hodgkin's lymphoma of the gastric stump 9 years after undergoing a distal gastrectomy for a gastric ulcer. The patient presented with epigastric discomfort, and an upper gastrointestinal series and gastroscopy revealed a lymphoma lesion located close to the site of his gastroduodenal anastomosis. A total gastrectomy was performed, followed by combination chemotherapy, comprised of vincristine, Endoxan, prednisone and Adriamycin (VEPA). Histologically, the resected specimen was diagnosed as non-Hodgkin's lymphoma. The patient has remained well without any signs of recurrence for 18 months since his operation. Although there have been a number of reports of adenocarcinoma developing in the gastric stump following surgery for peptic ulcers, the development of malignant lymphoma under such conditions is rare. Following the presentation of this case, we review the available literature and discuss the possibility of malignant lymphoma developing in the gastric stump.