大腸原発性悪性リンパ腫の1例

Primary Malignant Lymphoma of the Large Intestine, Report of a Case

要旨　患者は40歳男性．1986年初頭からの下痢・血便を主訴に同年4月当院受診．注腸造影，大腸内視鏡で直腸とS状結腸に潰瘍形成を伴う大きな腫瘍を認めた．腫瘍の立ち上がりはなだらかで，境界部の表面性状は周囲の正常部と同様で粘膜下腫瘍の所見を有していた．管腔は狭小化しているが，腫瘍の大きさに比し軽度で硬化像も少なく，伸展性が比較的保たれていた．これらの病変は病理組織学的にLSG分類でのlarge cell typeのdiffuse lymphomaであり，大腸原発であると考えられた．

　A 40 year-old man was admitted to our hospital because of diarrhea and hematochezia in the last four months. Barium enema study and colonoscopy revealed two large tumors with shallow ulcerations in the rectum and the sigmoid colon. Both of these two tumors had some features of the submucosal tumor by close observation by x-ray and endoscopy. Histopathological examination of the biopsy specimens showed diffuse lymphoma of large cell type (LSG).

　Two separate tumors looked like Borrmann type 2 as far as the resected specimens concerned. According to the Dawson's criteria, this case had two separate primary malignant lymphomas in the rectum and the sigmoid colon.