Primary gastric lymphoma with spontaneous perforation: report of a case. 
Primary gastric lymphoma with spontaneous perforation is rare.  We report herein the case of a 53-year-old-man who was admitted to our hospital with severe epigastralgia.  Emergency endoscopic examination showed a perforated gastric tumor in the lower body of the greater curvature, and a distal subtotal gastrectomy with lymph node dissection was performed.  The resected tumor measured 10.0 x 8.0 cm and was associated with an area of ulceration, 8.0 x 6.0 cm in size, and perforation, 1.0 x 0.5 cm in size.  Pathological examination confirmed a diagnosis of B-cell malignant lymphoma of the diffuse, medium-sized cell type.  According to the Ann Arbor and Naqvi classifications, the lymphoma was stage II and stage III, respectively.  Postoperative adjuvant chemotherapy comprising cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) was given.  The patient is currently well with no signs of recurrence, 2 years 4 months after his operation.