腸管悪性リンパ腫の治療―外科的治療―腹腔鏡下手術を含む

Surgical Treatment of Malignant Lymphoma in the Intestine

要旨　腸管悪性リンパ腫の自験例（小腸8例，大腸5例）を呈示し，悪性リンパ腫の外科治療について概説した．悪性リンパ腫では，穿孔などの緊急例が多いため病態に応じた治療が必要である．予定手術例では，MALTリンパ腫で粘膜下層までに限局する病変には局所切除で良好な予後が得られる．それ以深のMALTリンパ腫やdiffuse large B-cell lymphomaでは，所属リンパ節の郭清を伴う腸切除が必要である．腸切除には，腹腔鏡下の手術が低侵襲で有用である．

　Thirteen cases of malignant lymphoma in the intestine operated on in our institute were reviewed with reference to the literature. Emergent operation was often performed for malignant lymphoma of the intestine. Operative method should be selected according the condition of the patient, staging and histology of the tumor. Local excision would be the proper treatment modality for MALT lymphoma invading as far as to the submucosal layer. Colectomy with dissection of regional lymph nodes might be the recommended option for deeper MALT lymphomas and other types of B-cell lymphoma.