Helicobacter pylori除菌にもかかわらず腫瘍が消失しなかった胃MALTリンパ腫の1例

Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma which did not Improve despite Eradication Therapy for Helicobacter pylori Infection, Report of a Case

要旨　患者は50歳，女性．心窩部不快感を主訴に来院．初回の胃内視鏡検査で胃角部小彎に小さな潰瘍を認めた．通常の抗潰瘍剤の投与で治癒傾向が認められず，潰瘍の増悪を認めたため生検を施行，MALTリンパ腫と診断された．Helicobacter Pylori陽性のため除菌療法を施行した．除菌によりHelicobacter Pyloriの消失とともに内視鏡像も軽快した．生検組織学的には除菌後1年2か月間，経過観察中であるが，腫瘍細胞は消失することなく存続している．本例はHelicobacter Pyloriの除菌にもかかわらず，腫瘍が消失しない症例と考えられた．

　A 50-year-old female visited our clinic in February, 1995 with epigastric discomfort. Initial endoscopic examination revealed a small aphthoid ulcer on the lesser curvature of the angulus. H₂-blocker and omeprazole were subsequently given to the patient. The control examination showed the ulcer remained persistent. The endoscopic biopsy confirmed the lesion was MALT lymphoma. The examinations for Helicobacter pylori were positive. The eradication therapy was performed by lansoplazole, amoxicillin, metronidazole and rebamipide. Eradication for Helicobacter pylori was successfully obtained and endoscopic picture of the ulcer was improved. In spite of the improvement of the ulcer, the histological findings of biopsy specimens has continued to indicate MALT lymphoma for 14 months after eradication of Helicobacter pylori.