遺伝子再構成を認めHelicobacter pylori除菌療法にて消失した直腸良性リンパ濾胞性ポリポーシスの1例

Regression of Benign Lymphoid Polyposis of the Rectum with Detection of Immunoglobulin Heavy Chain Gene Rearrangement after Eradication of Helicobacter pylori, Report of a Case

要旨　患者は60歳台，女性．便潜血反応陽性にて検査施行され，下部直腸に多発の粘膜下腫瘍を認め，当科紹介精査となる．同部位に微小から6mmまでの半球状の表面平滑な多発する隆起性病変を認めた．EMR標本から，IgH遺伝子再構成を認めたが，組織学的検索にて良性リンパ濾胞性ポリポーシスと診断した．H. pyloriの感染は陰性であったが，除菌療法を施行したところ，病変の消退，消失を内視鏡上確認できた症例を報告した．

　A 60's woman was introduced to our hospital for further examination concerning positive fecal occult blood. Double contrast study of the lower rectum showed a lot of hemispheric polypoid lesions with smooth surface. Colonoscopy revealed many submucosal tumors in the rectum, measuring 6 mm in diameter. The resected specimen by EMR showed proliferation of normal lymphocytes forming lymph follicles. Although there was detection of immunoglobulin heavy chain gene rearrangement by polymerase chain reaction, the lesions were diagnosed as benign lymphoid polyposis of the rectum.

　The patient was negative for H. pylori, but we performed eradication of H. pylori. We proved the disappearance of the lymphoid polyposis by colonoscopy.