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Stomach and Intestine(Tokyo) Volume 43, Issue 7 （June 2008）

胃と腸 43巻7号（2008年6月発行）

Japanese English

今月の主題消化管follicular lymphoma―診断と治療戦略

主題

消化管濾胞性リンパ腫の臨床的特徴―MALTリンパ腫およびDLBCLとの比較 Clinical Features of Gastrointestinal Follicular Lymphoma: A Retrospective Study in Comparison with MALT Lymphoma and Diffuse Large B-cell Lymphoma 中村昌太郎 ¹ , 松本主之 ¹ , 梁井俊一 ¹ , 具嶋正樹 ² , 原田直樹 ³ , 八尾隆史 ^2,4 , 飯田三雄 ¹ Shotaro Nakamura ¹ , Takayuki Matsumoto ¹ , Shunichi Yanai ¹ , Masaki Gushima ² , Naoki Harada ³ , Takashi Yao ^2,4 , Mitsuo Iida ¹ ¹九州大学大学院医学研究院病態機能内科学 ²九州大学大学院医学研究院形態機能病理学 ³九州大学大学院医学研究院病態修復内科学 ⁴順天堂大学医学部人体病理病態学 ¹Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan ²Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan ³Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan ⁴Department of Human Pathology, Juntendo University School of Medicine, Tokyo キーワード：濾胞性リンパ腫 , 消化管リンパ腫 , 非外科的治療 , 予後 Keyword: 濾胞性リンパ腫 , 消化管リンパ腫 , 非外科的治療 , 予後 pp.1067-1079

発行日 2008年6月25日 Published Date 2008/6/25

DOI https://doi.org/10.11477/mf.1403101406

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要旨　消化管濾胞性リンパ腫32例の臨床的特徴を，MALTリンパ腫（n＝229）・diffuse large B-cell lymphoma（DLBCL；n＝214）と比較した．濾胞性リンパ腫のうち腸管原発群（n＝17）は，胃原発群（n＝15）と比べ，肉眼型でMLP型，組織ではGrade 1の頻度が高く，complete remission（CR）導入率は低かった．MALTリンパ腫・DLBCLと比較すると，濾胞性リンパ腫では腸管限局例の頻度が高く，病期進行例が多かった．濾胞性リンパ腫の66％で非外科的治療が行われ，CR導入率（66％）はMALTリンパ腫（89％）・DLBCL（85％）より低かった．予後は，DLBCLと同様で，MALTリンパ腫より不良であった．予後因子としては，CR導入の有無のみが有意なevent-free survival規定因子であった．

　The clinicopathological features of 32 cases of primary gastrointestinal follicular lymphoma were compared retrospectively with those of MALT lymphoma (n＝229) and of diffuse large B-cell lymphoma (DLBCL; n＝214). Among follicular lymphomas, primary intestinal cases (n＝17) more frequently showed macroscopic MLP type and histological Grade 1, but less frequently achieved complete remission (CR) than primary gastric cases (n＝15). Compared to cases of MALT lymphoma and DLBCL, follicular lymphoma cases more frequently had intestinal localization, and advanced stage. Non-surgical treatment was performed in 66％of the cases, and CR was achieved less frequently in follicular lymphoma cases (66％) than in cases of MALT lymphoma (89％) and DLBCL (85％). The prognosis of follicular lymphoma cases was similar to that of DLBCL, and was significantly worse than that of MALT lymphoma. Induction of CR was the sole significant prognostic factor for event-free survival, but not for overall survival, in cases of gastrointestinal follicular lymphoma.