食道原発MALTリンパ腫の1例

Primary MALT Lymphoma of the Esophagus, Report of a Case

要旨　患者は34歳の男性．健診目的の胸部X線検査で異常影を指摘され，PETで中縦隔に強い集積を認めた．CTおよびMR検査で食道と一塊となった腫瘍を疑われた．上部消化管X線検査では内腔は保たれ，食道の伸展は良好であった．上部消化管内視鏡検査，および超音波内視鏡検査ではびまん性の粘膜下層の肥厚を認めた．以上より，食道原発悪性リンパ腫と診断し，食道切除を行った．病理診断はMALTリンパ腫であった．R-CHOPによる化学療法を施行し，術後16か月現在まで再発はない．食道MALTリンパ腫はまれな疾患であり，治療法も確立していない．さらなる症例の集積と分析が必要である．

　A 34-year-old male was noticed to have a chest X-ray abnormality. PET demonstrated a strong spot in the middle mediastinal space. CT and MR suggested a mediastinal tumor, adhering to the esopagus. Upper gastrointestinal meal examination revealed good progress of the esophageal wall. Gastrointesitinal endoscopy and EUS showed diffuse thickness of the submucosal layer of the esophagus. Therefore, the patient was diagnosed as having primary malignant lymphoma of the esophagus. Esophagectomy was carried out. Pathological findings showed MALT lymphoma. Chemotherapy by R-CHOP was performed and there has been no relapse 16 months after the operation. Because this disease is very rare, and has no established treatment method, the accumulation and analysis of further case's are necessary.