腺癌成分がEBV陽性リンパ球浸潤胃癌であった腺扁平上皮癌の1例

Adenosquamous Carcinoma, with a Component of Carcinoma with Lymphoid Stroma Positive for EBER-1, a Case Report

要旨　50歳代，男性．1998年4月ごろからつかえ感を自覚．近医を受診し，上部消化管X線造影検査で胃角部の腫瘍を指摘されて当院に紹介され受診となった．上部消化管内視鏡検査では，胃角部の小彎中心にType 2病変を認めた．組織生検では低分化腺癌の結果であった．腹部CT造影検査では噴門部に10mm大のリンパ節腫大を認めたが，腹水・遠隔転移は認めなかった．1998年7月に胃全摘術，Roux-en Y再建を施行した．術後病理検査ではpT2N0P0CY0H0，pStage Ibの診断で，リンパ球浸潤癌と扁平上皮癌成分を認める腺扁平上皮癌であった．また，リンパ球浸潤癌の成分のみEBER-1が陽性であった．

　A male in his fifties underwent enema at a previous hospital because of dysphagia. Type 2 gastric tumor was pointed out, and he was referred to our hospital. Gastro-endoscopy revealed a Type 2 tumor in the lesser curvature of the angle. In histology, the biopsy specimen demonstrated poorly differentiated adenocarcinoma cells. An abdominal CT revealed a lymph-node swelling, 10mm in diameter, in the right cardiac region, but there was no evidence of distant metastasis and ascites. Pathological findings of the open total gastrectomy proved that the adenosquamous carcinoma, in which there was an adenocarcinomatous component included a carcinoma with lymphoid stroma positive for EBER-1 in situ hybridization.