胃MALTリンパ腫のHelicobacter pylori除菌後の経過―内視鏡像・病理組織像と治療後の変化

Clinicopathological Features of MALT Lymphoma

要旨　胃MALTリンパ腫に対してHelicobacter pylori（Hp）除菌療法が積極的に施行されている．本稿では，当科で経験した胃MALTリンパ腫の内視鏡像と病理組織像，治療後の変化について検討した．びらん性変化を種々の程度に伴う限局性，またはびまん性の発赤局面を呈する症例は，Hp除菌療法が奏効する症例が多く，リンパ腫細胞が消失した後の粘膜は，固有胃腺が消失し，粘膜内の線維化，浮腫による間質の増大を認め，内視鏡的には褪色粘膜面となった．一方，当初より褪色局面を呈する症例はHp陰性症例，他臓器に併存病変を有する症例などで認められた．これら症例間の臨床像や生物学的態度の違いについて更なる検討が望まれる．

　In 22 cases of gastric MALT (mucosa-associated lymphoid tissue) lymphoma, clinical features and endoscopic types were compared after administrotic of antibiotics. Endoscopy revealed four types: Diffuse granular redness, localized depressed redness, localized discolored area, and protruded lesion, respectively. Most of the diffuse granular redness types responded to Helicobacter pylori (Hp) eradication therapy, but, within six months after eradication of Hp, these cases might merely be in the remission stage. Cases of Hp negative MALT lymphoma and MALT lymphoma accompanied with disseminated lesions show discolored lesions in the stomach. These lesions are not affected by Hp eradication therapy. Thus, our study of the clinicopathological features of MALT lymphoma in 22 cases, led us to the conclusion that wider clinical trials are required to assess more fully the effects of eradication of Hp on gastric MALT lymphoma.