3年4ヵ月の逆追跡ができた胃悪性リンパ腫の1例

Malignant Lymphoma of the Stomach Followed Up for Three Years and Four Months

　3年4カ月の逆追跡ができた胃悪性リンパ腫の1例を報告する．

症　例

　患　者：56歳，女．

　主　訴：心窩部痛．

　臨床経過および検査所見　1975年1月，心窩部痛があり当院初診．

　A 56-year-old woman came to the Toranomon Hospital with a chief complaint of epigastralgia in January 1975 and was diagnosed as multiple gastric ulcers by first x-ray and endoscopic examinations. Three months later, the multiple ulcers proved to be scars. The patient did not come to the Toranomon Hospital from May 1975 to December 1976.

　As the patient was suspected of gastric cancer at another hospital, she returned to our hospital for taking a precise examination in January 1977. She was suspected to have early gastric cancer endoscopically. But the diagnosis of malignant lymphoma was not confirmed by biopsy at that time. So, she was followed up as gastric ulcer and multiple erosions until December 1977. The diagnosis of malignant lymphoma was confirmed by third biopsy performed in February 1978. Gastrectomy was performed in May 1978.

　On the resected specimen, there are several flat polypoid lesions with small erosion and fold convergence on the anterior wall of the angular portion. It is difficult to delineate the margin of the tumor. Histological diagnosis was malignant lymphoma, mixed L＆H (by Rappaport). Lymphomatous infiltration was limited to the mucosa and submucosa. Four out of 54 resected lymph nodes were involved.

　The patient is well three year after the operation.