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要旨 患者は69歳,女性.上腹部痛を主訴に近医を受診.胃内視鏡および胃X線検査を受け,胃角前壁に潰瘍を伴う隆起性病変を認めた.2回の生検(1回目,生検5個中5個に,2回目,生検4個中3個に各々悪性リンパ腫細胞を認めた)で,胃悪性リンパ腫と診断され手術目的のため当科に入院.入院後の胃X線および内視鏡検査では,潰瘍の縮小を認め,生検では腫瘍細胞を認めなかった.経過中,化学療法は施行せず,当初から抗潰瘍剤を,術前2週間よりH2antagonistを投与していた.切除標本上では腫瘍細胞は認めず,Ul-Ⅱの浅い潰瘍であった.その潰瘍底の粘膜下層には広汎な線維化を認め,腫瘍が存在していたと考え,潰瘍化により腫瘍が脱落し,自然消失に至ったものと思われた.
A 69-year-old woman was admitted to our hospital with complaint of epigastric pain. The endoscopic and x-ray examinations showed a large protuberant tumor with an ulceration in the anterior wall of the angulus (Figs. 2, 3). Endoscopic biopsy showed malignant lymphoma (Fig. 4). During 2 months and a half before operation, this tumor with an ulceration became smaller in size on x-ray and endoscopic examinations (Figs. 5-7). Microscopical examination of the resected specimen revealed marked fibrosis (Ul-Ⅱ) without lymphoma cells (Figs. 8-10). The malignant lymphoma regressed spontaneously in this case. These clinical and pathological findings suggested the existence of the so-called"malignant cycle" in malignant lymphoma.
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