癌と悪性リンパ腫による原発性胃衝突腫瘍の1例

Gastric Collision Tumor (Cancer and Malignant Lymphoma) with RLH, Report of a Case

要旨　患者は64歳，男性．胃潰瘍の経過観察中，胃体下部小彎にⅡc様病変を認め，胃癌の診断で胃亜全摘術を施行した．病理組織検査の結果，この病変（3.5×1.8cm）は，ほぼ中央部で相接した進行癌（tub2，ss）とB-cell系悪性リンパ腫（follicular lymphoma，partially follicular，mixed type，sm）との衝突腫瘍と診断された，また，この腫瘍より幽門側にRLHが広範囲に散在していた．リンパ節は1群③の3/7個に癌の転移が認められた．術後3年10か月で残胃にリンパ腫が再発し，化学療法中である．

　The patient was a 64-year-old man. A Ⅱc-like lesion was observed at the lesser curvature below the body of the stomach during a follow-up check on a gastric ulcer. Subtotal gastrectomy was performed with a diagnosis of gastric cancer. As a result of microscopic pathology, this lesion (3.5 × 1.8 cm) was diagnosed as collision tumor in which a cancer (tub 2, ss) was in contact with a B-cell type malignant lymphoma (follicular lymphoma, partially follicular, mixed type, sm). In addition, RLH were scattered extensively on the pyloric side of this tumor. Metastatic tumor was observed at three of seven lymph nodes of group 1③. Lymphoma recurred in the remaining stomach three years and ten months after operation and the patient is receiving chemotherapy now.