A 70-year-old man was admitted to the hospital because of leukocytosis, gastric cancer (wide spread OIIa) at the angular notch and gastric ulcer (H1 stage) at the posterior wall of the upper body of the stomach. The white cell count was 20, 500/μl with 78% lymphocytes and these were identified as B cells. Hematologic analysis led to the diagnosis of B cell type chronic lymphocytic leukemia (CLL). Total gastrectomy was performed. It was early gastric cancer (type OIIa+IIc, sm2, por2+sig) and had no lymph nodes involvement. Moreover, in part of gastric ulcer marked lymphocyte infiltration was noticed from the submucosal to subserosal layers and B cell type CLL was identified.
In Japan CLL occurs in a low frequency, but the frequency of associating with cancer is high. Cases of CLL associated with cancer are so few that only 37 cases have been reported after 1965 in the Japanese literature except our case. Gastric cancer is the predominant second cancer. As for cell type of CLL, B cell is more (19 cases) than T cell (7 cases). Gastrointestinal involement of CLL is rarely encountered and our case is the 9th in the literature.