血小板減少症を併発した胃悪性リンパ腫の1例

Malignant Lymphoma of the Stomach Combined with Thrombocytopenia, Report of a Case

要旨　患者は68歳，男性．タール便を主訴に受診し，精査で胃悪性リンパ腫と血小板減少症を指摘され胃全摘術を施行された．術前に測定した抗血小板抗体は陰性であったが，PA-lgGは高値を示し，また術後測定した腫瘍細胞培養上清中のPA-lgGも高値を示した．本邦での悪性リンパ腫と血小板減少症の合併例は最近10年間で10例の報告がなされているが，腫瘍細胞培養上清中のPA-IgGを測定した報告例はなく，両者の関係を説明するうえで興味深い症例と考えた．

　A 68-year-old man was referred to our hospital because of tarry stool. Barium meal examination revealed a well circumscribed, elevated lesion with central depression at the anterior wall of the corpus of the stomach. The laboratory examination showed thrombocytopenia and a high expression of platelet associated IgG (PA-lgG). No anti-platelet antibody was detected. After thrombocytopenia was corrected by transfusion of plateled rich plasma and additionally by infusion of a high amount of gamma globulin, total gastrectomy and splenectomy were performed for malignant lymphoma of the stomach and thrombocytopenia. The cells from gastric tumors were cultured in 10% FCS-RPMI and a number of PA-lgG in its supernatant was detected. In our survey, ten cases of malignant lymphoma combined with thrombocytopenia have been reported in the last ten years in Japan.