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要旨 症例は46歳,女性.嚥下困難を主訴に近医を受診し,下部食道に粘膜下腫瘍(SMT)を認め,当科を紹介受診となった.食道X線検査では大きさ12cmの中央に陥凹を有するSMTとして描出された.上部消化管内視鏡検査では白色調,弾性硬のSMTであり中央に深い陥凹を有していた.食道原発の悪性リンパ腫と診断したが,生検では確定診断に至らなかった.診断的治療として胸部食道亜全摘術を施行した.切除後の病理組織検査にて小型の異型リンパ球が増殖し,centrocyte-like cellの増殖,lymphoepithelial lesionを認めた.免疫染色ではCD20,bcl-2陽性,CD5,CD10,cyclin-D1陰性で食道原発のMALTリンパ腫と最終診断した.術後15か月無再発にて経過観察中である.
A 46-year-old woman visited a local doctor with dysphagia as her chief complaint and was referred to our hospital for further examination and the treatment of esophageal submucosal tumor. Our endoscopy view showed a longitudinal smooth elevated lesion, 12 cm in size, in the lower esophagus, which was covered with normal mucosa and with a deep depression on the top. Endoscopic urtrasonography showed a hypo-echoic mass located in the submucosal layer. Biopsy specimen taken from the depression showed a malignant lymphoma. The patient underwent surgery, which confirmed the mass to be a primary mucosa-associated lymphoid tissue (MALT) type lymphoma.
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