HTLV-1感染者の上部消化管病変

Characteristics of Upper Gastrointestinal Tract Lesions in Patients with Adult T-cell Leukemia/Lymphoma

要旨　ATL/Lの上部消化管病変について，自験例238例を対象として検討した．ATL細胞浸潤による消化管病変は臓器特異性があり，胃では混在型が，十二指腸では多発隆起型が多くみられた．B細胞性リンパ腫や，T細胞性リンパ腫と比較すると，多発性，びまん性の傾向がみられた．他臓器の癌が10.1％と高頻度に合併しており，免疫能の低下が関与していると推察された．上部消化管の日和見感染は1.3％にみられ，下部消化管の日和見感染や腫瘍細胞浸潤を合併した症例では，死に至る重篤な状態を引き起こしていた．良性病変は35.8％に認められ，なかでも消化性潰瘍が8.03％と高頻度に合併していた．

　We examined upper gastrointestinal lesions in 288 patients with ATL/L（adult T-cell leukemia/lymphoma）treated at our hospital. The gastrointestinal lesions caused by ATL showed organ specificity, i.e., mixed type in the stomach and multiple protrusions in the duodenum. Compared to B cell or T cell lymphomas, larger numbers of multiple and diffuse lesion were detected. Carcinoma in other organs showed a high incidence rate of 10.1％, probably because of the patients'immunocompromised status. Opportunistic infections were found in the upper gastrointestinal tract in 1.3％ of cases. Some patients with opportunistic infections or invasion of ATL cell in the lower intestine had lethal condition. The incidence rate of benign lesions was 35.8％ ; especially, the incidence of ulcers in the digestive tract was high（8.03％）.