診断に苦慮し，経過観察中にNK/T細胞リンパ腫を発症した多発小腸潰瘍の1例

Natural Killer/T Cell Lymphoma, during a Follow-up of Multiple Ulcers in the Small Intestine, whose Differential Diagnosis was Diffcult, Report of a Case

要旨　症例は47歳，男性．腹痛と下血を主訴に来院した．ダブルバルーン式小腸内視鏡検査では，回腸全域に多発する小潰瘍を認めた．生検組織からは，炎症細胞浸潤のみで特異的な所見はないと報告された．経過観察中，約3年後に睾丸腫脹と疼痛を認め，泌尿器科にて睾丸摘出術を施行，NK/T細胞リンパ腫と診断された．化学療法準備中であったが，状態は急激に悪化し永眠された．その後の病理組織学的検討で，小腸と皮膚の初回生検組織よりNK/T細胞リンパ腫ならびにEpstein-Barr virusが証明された．

　We report here a case of a 47-year-old Japanese man who was brought to our hospital with the complaint of abdominal pain and bloody anal discharge. Initial double-balloon enteroscopy revealed multiple small ulcers throughout the whole ileum. The biopsy specimen revealed non-specific inflammation. During a follow-up for about three years, he experienced swelling of the testicles and sharp pain.

　The patient was admitted to the urology department and underwent orchidectomy. Histology of the resected specimen showed NK/T-cell lymphoma. The patient died a few months after the surgery because of the progression of the disease.

　Histopathology examination after his death, from the first biopsy of the small intestine and the skin, revealed NK/T cell lymphoma and EBV.