表層型胃悪性リンパ腫の鑑別診断―X線診断―表層型胃悪性リンパ腫と慢性胃炎

Differential Diagnosis and Delineation of Findings by the Radiologic Examination, Superficial Gastric Malignant Lymphoma and Chronic Gastritis

要旨　表層型胃悪性リンパ腫病変（MALTリンパ腫を含む）19例を対象に，X線診断の立場から背景粘膜の組織所見について検討した．背景粘膜は粘膜萎縮が軽度な粘膜領域に存在し，胃底腺粘膜領域に多いことがわかった．慢性胃炎の組織所見の1つとされるリンパ濾胞の増生所見は全例に認められ，中等度以上のリンパ濾胞の増生が多かった．表層型胃悪性リンパ腫のX線ならびに内視鏡的診断には，1）これまで集積された肉眼ならびにX線・内視鏡所見，2）生検組織診断から得られた異型性のあるリンパ球増生所見，3）病変が存在する場（背景粘膜）の性状，などを考慮に入れた診断が必要であると思われた．

　For evaluating histological findings of the background mucosa around the lesion, nineteen cases of superficial gastric malignant lymphoma including MALT lymphoma were analyzed. The background mucosa was located in the mild atrophic mucosal area and commonly seen in the fundic gland mucosal area. All cases had hyperplasia of the lymph follicles, which was one of the histological findings of chronic gastritis. Most of the cases accompanied with more than moderate degree of hyperplasia of the lymph follicles. Radiologic and endoscopic diagnosis of the superficial malignant lymphoma needs to be made based on 1) the macroscopic and morphological findings of the radiologic and endoscopic examination, 2) the histological findings of hyperplasia of atypical lymph cells by the biopsy specimens, 3) the nature of background mucosa around the lesion.