特異な病理組織所見を呈した胃平滑筋腫の1例

Leiomyoma of the Stomach with Atypical Histology, Report of a Case

要旨　貧血を主症状として発症し，特異な病理所見を呈した36歳，女性の胃平滑筋腫を報告した．本例の幽門部前壁にみられた4.0×3.8×2.0cmの隆起性病変はX線像，内視鏡像からは非典型的ながら粘膜下腫瘍と診断しうる所見であったが，病理組織学的には腫瘍は炎症性細胞浸潤と毛細血管の増生の強い肉芽性変化より成り，平滑筋組織は潰瘍辺縁部にわずかに認められるのみであった．本例は平滑筋腫の中心より急激な平滑筋組織の崩壊が生じたのち，その部に肉芽性変化が強く出現し，特異な組織所見を呈したものと考えられる．

　A 36 year-old female patient presented with severe anemia (hemoglobin level 6.2 g/dl) . Upper gastrointestinal series x-ray photograph and endoscopy revealed a submucosal tumor in the anterior wall of the antrum. Consequently, partial gastrectomy was carried out. Pathological findings of the resected specimen were as follows : the tumor being mainly composed of the granulomatous tissue with infiltration of inflammatory cells and capillary growth, ulceration in the center, leiomyoma tissue only in the marginal zone of ulceration. Our speculation is that atypical histology in this case was the result of the rapid granulation following the central ulceration of the tumor tissue.