Phlegmonous gastritis developed during chemotherapy for acute lymphocytic leukemia: A case report

Figure 1 Clinical course of this patient. Ara-C: Cytarabine; ETP: Etoposide; Dex: Dexamethasone; IT: Intrathecal injection; G-CSF: Granulocyte-colony stimulating factor; BIPM: Biapenem; MEPM: Meropenem; IVIg: Intra-venous immunoglobulin; WBC: White blood cell count; CRP: C-reactive protein.

Figure 2 Abdominal computed tomography (day 11). Marked thickening of the gastric wall (orange arrow), suggestive of hepatic portal venous gas (white arrow), and low-density areas (blue arrow) were found.

Figure 3 Esophagogastroduodenoscopy. A-C: Marked thickening of the gastric wall in the corpus of the stomach and yellow-green pseudomembrane-like tissue covering the superficial mucosa were observed (day 14); D: The above abnormal findings were improved, and linear redness, erosion and ulcerative mucosal changes were observed (day 29).

Figure 4 Abdominal computed tomography (day 29). The thickening of the gastric wall was improved, and signs suggestive of hepatic portal venous gas disappeared. The low-density areas in liver S3 and S7 observed 18 d ago were changed the findings consistent with abscesses (blue arrow).

Figure 5 Histopathology of the gastric biopsy. A: Mostly necrotic tissue and partly infiltration by lymphocytes were observed (hematoxylin & eosin stain); B: Bacilli were gram-positive (gram stain).