多発微小陥凹を呈した胃MALTリンパ腫の1例

Gastric MALT Lymphoma Showing the Features of Multiple Minute Hollow Spots, Report of a Case

要旨　患者は35歳，女性。1996年ごろから心窩部不快感を自覚しており，1998年6月当科を受診した．上部消化管内視鏡検査で胃体中部から下部の小彎に縦走発赤と微小な陥凹性変化が多発しており，微小陥凹からの生検組織でMALTリンパ腫と診断された．胃X線二重造影像でも内視鏡所見の陥凹部に一致して微小バリウム斑を確認できた．外科的切除材料の病理組織学的検索では胃体上部から下部の小彎で粘膜固有層の深層部から粘膜下層にかけてlymphoma cellの浸潤増殖を認めた．ごく一部では表層上皮近くまでlymphoma cellが浸潤し，粘膜表層にわずかな陥凹性変化を来していた．

　A case of gastric mucosa-associated lymphoid tissue (MALT) lymphoma showing the feature of multiple minute hollow spots at the lesser curvature of the gastric body is reported. The patient was a 35-year-old female with the chief complaint of epigastric discomfort. The endoscopic examination of the stomach revealed a lot of reddish and minute hollow spots on the vertical folds at the lesser curvature of the lower body. Histological diagnosis of the biopsy specimen from the area of a minute hollow spot was MALT lymphoma.

　Radiographic examination also recognized minute barium flecks corresponding with the endoscopic findings.

　Histopathological examination of the resected specimen recognized diffuse infiltration of lymphoma cells from the deep part of the mucosa to the submucosa at the lesser curvature of the upper to lower body, and a small depressed change at the surface epithelium was noted.