除菌療法後4年経過した胃MALTリンパ腫の1例

Gastric MALT Lymphoma Which has been Improved by the Eradication of Helicobacter pylori during Four Years Observation Period after the Treatment, Report of a Case

要旨　患者は39歳の女性．検診で胃潰瘍性病変を指摘され近医受診，胃内視鏡検査・生検の結果malignant lymphomaを疑われ，精査加療日的で当院紹介受診した．胃内視鏡検査再検にて胃前庭部後壁に不整潰瘍性病変を認め，生検の結果MALT lymphoma，low-gradeと診断，Helicobacter pylori陽性であったため，十分なインフォームドコンセントの下，除菌療法を施行した．除菌成功にて潰瘍部は領域性を持った自色の軽度粗糙粘膜所見を呈するのみとなり，生検もリンパ腫陰性となった．以後，年1回の胃内視鏡検査にて経過観察を続けているが，除菌後4年でも内視鏡所見に著変なく，生検上もリンパ腫は認められていない．

　A 39-years-old female was refered to our hospital, because of malignant lymphoma of the stomach suspected endoscopically and histologically by another hospital. Our initial endoscopic examination also revealed an irregular shaped and shallow ulcerative lesion in the posterior wall of gastric antrum, strongly suggested malignant lymphoma, and histological examination of biopsy specimens revealed low-grade MALT (mucosa-associated lymphoid tissue) lymphoma. Helicobacter pylori (H. pylori) infection was also detected histopathologically and serologically. After the successful eradication of H. pylori, the ulcerative lesion was healed, and showed a whitish mucosal area with coarse surface and uncertain border. Histological findings of biopsy specimens became unable to indicate MALT lymphoma cells. And during four years observation period after the eradication, endoscopic findings have been almost stationary, and no evidence of MALT lymphoma has been detected histologically.