成人T細胞性白血病・全身性悪性リンパ腫にみられた大腸微細病変

Minute Lesions of the Colon in Patients with Adult T-cell Leukemia and Systemic Malignant Lymphoma

要旨　未治療の成人T細胞性白血病3例と全身性悪性リンパ腫2例について大腸病変の有無をX線および内視鏡検査で検索した．5例中4例に1～7mmの微細病変が認められ，病変部からの生検では全例に腫瘍細胞とみなされる異型リンパ球の浸潤を証明した．化学療法により微細病変はほとんど消失し，治療後の生検標本には異型リンパ球を証明しなかった．未治療の成人T細胞性白血病や全身性悪性リンパ腫には大腸に高頻度に病変が存在するが，病変自体が微小・微細なために見逃されている可能性が高いと考えられた．

　Colonofiberscope and barium enema were performed consecutively in five patients with lymphoproliferative disease, diagnosed at our clinic from July 1987 to April 1989. Three of the patients had untreated adult T-cell leukemia. The after two patients had untreated systemic malignant lymphoma. We endeavored to detect colonic lesions in such patients. Minute lesions of 1-7 mm in size were noted in four of the five cases, and biopsy specimens taken from these minute lesions revealed, in all four cases, infiltration of leukemic cells.

　Chemotherapy made these minute lesions disappear almost completely, and post-treatment biopsy found no leukemic cells.

　Thus, it is likely that these minute lesions would exist at a rather high, incidence in the pre-treatment state of these diseases.