继发性淀粉样变性是一个确立的疾病实体，并已描述与类风湿性关节炎、强直性脊柱炎、支气管扩张症、结核病等慢性炎症疾病有关。它也被报道与霍奇金淋巴瘤、瓦尔登斯特龙氏巨球蛋白血症、肾细胞性癌、肺癌等肿瘤有关。然而，文献中只有少数几例描述了淀粉样变性与胃肠道肿瘤（GIST）和胃腺癌的关联。在这里，我们报告一例74岁男性患者，出现绞痛性腹痛和呕吐。超声检查显示胆总管结石和小的胃外壁肿块。行经内窥镜逆行胆道胰管造影（ERCP）以取出胆总管结石，此过程中意外发现胃溃疡。从胃溃疡处取了活检标本，组织病理学检查证实为腺癌，随后行全胃切除术。在全胃切除术中，脾脏被意外损伤，导致同时进行脾切除术。从胃溃疡、胃外壁肿块和脾脏中取得多个样本，进行组织病理学检查。胃溃疡证实为腺癌，胃外壁肿块证实为GIST，脾脏检查显示蛋白淀粉样变性广泛沉积，刚果红染色在偏光显微镜下呈苹果绿双折射现象。据我们所知，这是首次报道出现胃腺癌伴发的同时存在胃GIST和脾脏继发性淀粉样变性的病例。

Secondary amyloidosis is a well-established entity and has been described in association with chronic inflammatory conditions such as rheumatoid arthritis, ankylosing spondylitis, bronchiectasis, tuberculosis, etc., It has also been reported in association with neoplasms such as Hodgkin's lymphoma, Waldenstrom's macroglobulinemia, renal cell carcinoma, lung carcinoma, etc. However, only a few case reports documenting the association of amyloidosis with gastrointestinal tumor (GIST) and gastric adenocarcinoma are available in the literature. Hereby, we report a case of a 74-year-old male who presented with colicky abdominal pain and vomiting. Ultrasonography revealed a common bile duct (CBD) stone and a small extra-luminal gastric mass. Endoscopic retrograde cholangiopancreatography (ERCP) was performed to remove the CBD stone which revealed an incidental finding of gastric ulcer. A biopsy was taken from the gastric ulcer which on histopathological examination was confirmed as adenocarcinoma leading onto total gastrectomy. During total gastrectomy, an inadvertent injury to the spleen led to simultaneous splenectomy. Multiple samples from the gastric ulcer, the extra-luminal gastric mass, and the spleen were subjected to histopathological examination. Gastric ulcer was confirmed as adenocarcinoma, gastric extra-luminal mass was confirmed as GIST, and splenic examination revealed widespread deposition of amyloid which on Congo-red stain imparted an apple-green birefringence on polarizing microscopy. To the best of our knowledge, this is the first-ever case of such an association where gastric adenocarcinoma occurred with concomitant gastric GIST and secondary amyloidosis of the spleen.