結節集簇様を呈したS状結腸の原発性早期悪性リンパ腫の1例

Primary Early Malignant Lymphoma of the Sigmoid Colon, Resembling Nodule-Aggregating Tumor Appearances, Report of a Case

要旨　S状結腸に限局した，結節集簇様の形態を呈した原発性悪性リンパ腫を経験した．患者は71歳，男性．血便を主訴に，1993年3月某医を受診し，早期直腸癌を発見され，4月1日当科に紹介入院となった．入院後の大腸内視鏡検査および注腸X線検査で，S状結腸に表面平滑な結節が集簇した隆起性病変を認めた．生検診断で悪性リンパ腫と診断し，表在リンパ節，肺門部，他の臓器などに病変を認めないことからS状結腸切除を行った．腫瘍径は13×10mmで，病理組織学的検索では，non-Hodgkin's lymphoma，medium-sized cell type（LSG）であり，深達度はsmで，リンパ節転移は認めなかった．

　A 71-year-old man was admitted to our hospital because of a early rectal cancer, which had been detected at another hospital which he had first visited complaining of bloody stool. Double contrast barium enema and colonoscopy revealed an elevated lesion with smooth surface, which resembled nodule-aggregating tumor in appearance, in the Sigmoid colon. Biopsy specimen obtained from this lesion showed malignant lymphoma. Histopathological examination of the resected specimen revealed non-Hodgkin's lymphoma, medium-sized cell type (LSG). The depth of tumor invasion was limited to the mucosa and submucosa, and no lymph node metastasis was detected.