[A Case Report of Difficult Esophagojejunal Anastomosis for Multiple Primary Cancer of Malignant Lymphoma and Gastric Cancer].

A 54-year-old man presented with cervical lymph node swelling and exhibited high levels of sIL-2R. Enhanced cervical, chest, and abdominal CT scanning demonstrated swelling of the cervical, hilar, axilla, and abdominal lymph nodes. The patient was diagnosed with malignant, non-Hodgkin's lymphoma, B-cell, follicular lymphoma using biopsy of the cervical lymph nodes. Gastrointestinal endoscopy revealed II c like advanced tumor in the upper gastric body and post-wall area. He was diagnosed with primary multiple cancer comprising malignant lymphoma and gastric cancer. It was difficult to elevate the jejunum for esophagojejunal anastomosis due to the giant abdominal lymph node swelling. The patient received 5 courses of combination R-CHOP chemotherapy for malignant lymphoma. The swollen lymph nodes considerably reduced in size after chemotherapy. Totalgastrectomy with reconstruction using the Roux-en-Y method was performed for gastric cancer. Histopathological findings revealed pT3(SS), pN0, pH0, pP0, pStage I B. The patient achieved complete remission following another course of chemotherapy and involved field radiation therapy. At present, he shows no signs of recurrence of primary multiple cancer.