胃多発性濾胞性リンパ腫の1例

A Case of Gastric Multiple Follicular Lymphoma

　近年胃のX線検査，内視鏡検査，細胞診，直視下生検などの検査法の発達は著しく，胃癌をはじめとする各種胃疾患の診断治療を容易ならしめるとともに，臨床病理学的知見の進歩に大きく貢献している．しかし胃癌や胃潰瘍に比べ胃リンパ腫やその類縁疾患は発生頻度も低く，その臨床病理学的知見の確立にはなお個々の症例の集積や解析が必要と思われる．

　筆者らは最近臨床的にⅡc型早期胃癌と考えられ，生検組織の鏡検においてreactive lymphoid hyperplasia（以後RLHと略す）を示唆されたが，最終的には切除胃の組織学的検索によって多発性濾胞性リンパ腫と診断された1例を経験したので，その臨床経過の概要と病理学的知見を報告する．

　Clinicopathological findings of a case of gastric multiple follicular lymphoma are presented. The patient, a 61-year-old man, had melena, gastric pains and vomiting. X-ray and endoscopical examinations suggested an early gastric cancer (Type IIc). Biopsy specimens obtained from the eroded surface of the depression on the lesser curvature of the corpus led us to suspect reactive lymphoid hyperplasia of the stomach (RLH). However, the resected stomach had characteristic histological features of well differentiated lymphocytic lymphoma, nodular type.

　Grossly, the stomach showed five tumors located at anterior and posterior walls of the corpus. Both superficial and elevated types of the tumor were seen. There were no ulcerated lesions.

　Histological appearance of the five tumors was essentially similar showing nodular or follicular proliferation of well differentiated lymphocytoid cells. Neither fibrosis, inflmmatory cell infiltration nor germinal center was observed.