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International Journal of Surgical Pathology
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Regression of Gastric Large B-Cell Lymphoma Accompanied by a Florid Lymphoma-like T-Cell Reaction: Immunomodulatory Effect of Ganoderma lucidum (Lingzhi)?

Wah Cheuk, MBBS

Department of Pathology, Queen Elizabeth Hospital, Wylie Road, Kowloon, Hong Kong

John K. C. Chan, MBBS

Department of Pathology, Queen Elizabeth Hospital, Wylie Road, Kowloon, Hong Kong, e-mail: jkcchan{at}ha.org.hk.

Gerard Nuovo, MD

Department of Pathology, The Ohio State University, Columbus, Ohio

May K. M. Chan, MBBS

Hong Kong Sanatorium, Hong Kong

Manson Fok, MBBS

Hong Kong Sanatorium, Hong Kong

Complete regression of high-grade lymphoma is extremely rare. We report 1 such case that might have been conceivably mediated by Ganoderma lucidum (Lingzhi), an immunomodulatory herbal medicine. A 47-year-old man presented with epigastric pain. Endoscopy revealed a large gastric ulcer, which on biopsy was diagnostic of large B-cell lymphoma. At gastrectomy 11 days later, no evidence was found of large B-cell lymphoma despite thorough sampling. Instead, there was a dense and permeative infiltrate of CD3+ CD8+ cytotoxic small T lymphocytes spanning the whole thickness of the gastric wall. In situ reverse transcription polymerase chain reaction for T-cell receptor ß-chain family did not detect a monoclonal T-cell population. We postulate that the cytotoxic T cells may represent an active host–immune response against the large B-cell lymphoma that resulted in a complete regression. On questioning, the patient had taken megadoses of Ganoderma lucidum, which might have triggered the successful immune reaction.

Key Words: gastric lymphoma • lymphoma regression • Ganoderma lucidum

International Journal of Surgical Pathology, Vol. 15, No. 2, 180-186 (2007)
DOI: 10.1177/1066896906295890
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