Hodgkin's Disease of the Stomach

Cases of proved Hodgkin's disease of the stomach are relatively rare. It seems therefore well worth while reporting the following case, particularly as the radiological appearances were of a rather unusual type. Previous history: Male, aged 60 years. Had suffered from intermittent abdominal pain which came on in the evening about once a week, was not related to meals, and lasted about two hours. It was relieved by soda-bicarbonate. His last attack of pain of this sort was three years ago. Present history: Two months ago patient developed epigastric discomfort one hour before meals and relieved by food. But meals were followed by severe pains about the umbilicus. The pains became gradually more severe. Otherwise the patient was fairly well. Appetite normal. No vomiting. Examination: A rather wasted elderly man, with a sallow complexion. Mucous membranes rather pale. No enlarged glands, chest normal. Abdomen normal. Blood count: Erythrocytes 4,800,000. Hæmoglobin: 85 per cent. Colour index: 8. Leucocytes, 6·560. No differential count done. Fractional test meal—no free HC1. Occult blood test: Negative. X-ray examination: The chest was normal. Barium meal: Marked hypertrophic gastritis with rigid folds (Fig. 3). Changes extending from cardia to pylorus (Fig. 4). Peristalsis: Very sluggish and almost invisible at the middle part of the lesser curvature. Constant indrawing at the greater curvature just above the angle of stomach (Figs. 1 and 2). Radiological conclusion: Generalised disease of the stomach in the sense of a hypertrophic gastritis with infiltration of the deeper layers.