左舌根扁桃治療後胃・盲腸部に併発したリンパ肉腫症例

The Case of Lymphosarcoma Involved Primary at the Left Tonsilla and Secondary at the Stomach and Caecum

　消化管の悪性腫瘍は，その大部分が癌腫であって，肉腫は悪性腫瘍中4％（Irvine）で比較的稀なものとされている．その内でも胃では細網肉腫および平滑筋肉腫が多く，我国では胃淋巴肉腫の報告はきわめて少ない．また大腸肉腫も同様の傾向を有している．我々は最初に左舌根扁桃に原発と思われる腫瘤を見，組織学的に淋巴肉腫の診断で，コバルト照射により治癒し，その約2年後に消化管症状を現わし，胃および盲腸部の腫瘤を発見され，その手術2年後の現在も元気で生存中の胃および盲腸部淋巴肉腫症例を経験したので報告する．

　A case of 61-year-old male with lymphosarcoma of the left tonsilla treated by Cobalt irradiation and 2 years later involved lymphosarcoma secondary at the stomach and caecum is reported in the this paper.

The tumor of left tonsilla disappeared by Cobalt irradiation (total dosis 3,750γ). After 2 years, the patient complained the weight-loss and distention of the abdomen. Tumors at the epigastrium, ileocaecal region, bilateral axillar and inguinal lymphnodes were palpated. And splenomegalia wed found, too. Radiological examination revealed the tumor in the epigastric and ileocaecal region are localized at the stomach and caecum. Histopathologic diagnosis of biopsy specimen from the tumor of the stomach was lymphosarcoma.

　Tumor of the stomach and caecum was resected by surgical procedures. And granulomas of eggs of Schistosomiasis japonicum at the serosal wall of the urinary bladder were also resected at the same time.

　The histopathologic study of rescected specimens revealed that the tumors at the stomach and caecum were lymphosarcoma, same type with the left tonsilla.

　The patient is well now after 2 years of surgical treatment.

　The case of lymphosarcoma with tonsilla, stomach and caecum is very rare.