大腸に多発表在性にみられたMALT型悪性リンパ腫の1例

Multiple MALT Lymphoma Showing Superficial Changes at the Colon, Report of a Case

要旨　患者は65歳，男性．下痢と左下腹部痛を主訴に来院・注腸X線検査と内視鏡検査で下行結腸・横行結腸・上行結腸に小顆粒状の粘膜不整，顆粒間に溝状のびらん，軽度の粘膜下隆起をみた．確定診断のためにstrip biopsyを施行した．病理組織学的および免疫組織化学的に悪性リンパ腫を強く疑い，更にDNA再構成の検索により最終的にMALT lymphomaと診断した．治療としてはCHOPによる化学療法を行い，完全寛解を得た．本例は大腸悪性リンパ腫，特にMALTリンパ腫の初期像と考えられた

　A 65-year-old man was referred to our unit because of diarrhea and lower abdominal pain. Barium enema and endoscopic examinations revealed multiple granular mucosa and groovy erosions in the descending, transverse and ascending colon. Endoscopic mucosal resection was performed for the diagnostic purposes. Microscopic examination of the resected specimen suggested MALT lymphoma. Rearrangement of the immunoglobulin gene was detected. He was treated with CHOP chemotherapy, and achieved a complete remission. This is a rare case showing the early stage of gastrointestinal MALT lymphoma.