小腸平滑筋肉腫の1例

Leiomyosarcoma in the Small Intestine

近年小腸病変の診断技術の進歩に伴い小腸腫瘍の報告も少なからずみられるようになってきたが，われわれは最近空腸平滑筋肉腫の1例を経験したので報告する．

　A 50years old man was admitted to our hospital with chief complaint of melena. Physical examination on admission revealed tenderness and resistance at the mid-abdomen. Small bowel study of barium meal demonstrated polypoid lesion measuring about 3cm in diameter located 10cm distal to the Treitz ligament. Compression study revealed that the margin of the lesion was clear and no ulceration was seen on the surface of the lesion. These x-ray findings strongly suggested leiomyoma in the upper part of the jejunum. On the 29th hospital day, surgical operation was performed. The tumor measuring 2.5×2.0cm in size was located in the upper part of the jejunum, 10cm distal to the Treitz ligament. Invagination caused by the tumor was also found in the same region. The resected tumor showed both endoenteric and exoenteric growth. No ulceration was seen on the surface of the tumor. Histological study revealed that the tumor was composed of smooth muscle fiber bundles, in part of which mitosis was found. The histological diagnosis was leiomyosarcoma.