残胃に5年後再発した胃細網肉腫の1例

Recurrent Gastric Reticulum Cell Sarcoma in the Remnant Stomach at Five Years after Operation

　胃細網肉腫手術後の残胃に5年後再発した胃細網肉腫の1例を経験したので報告する．

症　例

　患　者：57歳，男．

　主　訴：心窩部重圧感．

　既往歴：1943年，右胸膜炎．1957年，交通事故にて右腎臓摘出術．1958年，虫垂切除術．1971年，脳血栓．1974年，胃細網肉腫にて胃切除術．

　家族歴：父，脳卒中．

　現病歴：1979年3月ごろから夜間の胸部絞扼感が出現し，近医にて心電図に異常なしと言われた．その後，夜間の心窩部重圧感も覚えるようになり，同年7月2日当科を受診し，胃X線検査にて異常を指摘されて入院した．

　A 57-year-old man had felt epigastric heaviness for four months. This patient underwent an operation five years before for multiple reticulum cell sarcomas of the stomach, which were respectively similar to Borrmann 2 type carcinoma and gastric ulcer. The present roentgenographic examination of the upper gastrointestinal tract revealed an ulcerative leson and the surrounding translucency which was, in part, disfigured in the remnant stomach. Considering the size of the lesion, however, the extension of walls of the stomach was well preserved. Endoscopic findlings were similar to roentgenoraphic finings, and biopsy revealed reticulum cell sarcoma. Angiography and lymphangiogaphy showed no abnormality in any of the other organs. Thus, it was diagnosed as gastric reticulum cell sarcoma which recurred in the remnant stomach, and performed an operation. Gross inspection of the resected stomach showed so-called auricle-like findings. Histologically, diffused proliferation of cells with ovoid or polygonal nuclei were observed in areas from the mucosal surface to the serosa.