Regression of gastric large B-Cell lymphoma accompanied by a florid lymphoma-like T-cell reaction: immunomodulatory effect of Ganoderma lucidum (Lingzhi)?

Int J Surg Pathol. 2007 Apr;15(2):180-6. doi: 10.1177/1066896906295890.

Abstract

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 beta-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.

Publication types

  • Case Reports

MeSH terms

  • Antigens, CD / metabolism
  • Biomarkers, Tumor / metabolism
  • Drugs, Chinese Herbal*
  • Endoscopy, Gastrointestinal
  • Gastrectomy
  • Humans
  • Immunologic Factors
  • Lymphoma, B-Cell / drug therapy*
  • Lymphoma, B-Cell / immunology
  • Lymphoma, B-Cell / pathology
  • Lymphoma, Large B-Cell, Diffuse / drug therapy*
  • Lymphoma, Large B-Cell, Diffuse / immunology
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Male
  • Middle Aged
  • Reishi*
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / immunology
  • Stomach Neoplasms / pathology
  • Stomach Ulcer / etiology
  • Stomach Ulcer / pathology
  • T-Lymphocytes, Cytotoxic / immunology*

Substances

  • Antigens, CD
  • Biomarkers, Tumor
  • Drugs, Chinese Herbal
  • Immunologic Factors