十二指腸悪性リンパ腫と早期胃癌を合併した1例

Malignant Lymphoma of the Duodenum with Early Gastric Carcinoma, Report of a Case

　十二指腸原発の肉腫は比較的まれで，わが国でも平滑筋肉腫の報告は多いが，悪性リンパ腫の報告例は少ない．われわれは十二指腸上部原発の悪性リンパ腫と，幽門輪部の早期胃癌を合併した1症例を経験したので報告する．

　The patient, 66-year-old man, had been suffered from epigastralgia and had general fatigue during a year. Upper gastrointestinal series showed an irre-gular filling defect with deep niche at the post-bulbar portion of the duodenum, and a small elevated lesion at the base of the duodenal bulb. Upper gastrointestinal endoscopy revealed a deep ulceration with surrounding edematous mucosa at the post-bulbar portion of the duodenum, and a small elevated lesion at the base of the duodenal bulb.

　Malignant submucosal tumor at the post-bulbar portion of the duodenum was suspected. This lesion was resected by pancreatico-duodenectomy. This size of the tumor was about 4 cm in diameter. The microscopic examinations showed malignant lymphoma of the duodenum (non-Hodgkin, diffuse, mixed type) with infiltration into common bile duct. The small elevated lesion, which appeared to be at the base of the duodenal bulb, was situated at the pylorus, and it proved to be early carcinoma of the pylorus histologically. The prolaps of the pyloric lesion into the duodenum made the filling defect at the base of duodenal bulb. Malignant lymphoma of the duodenum is extremely rare.

　This case is the first report of malignant lymphoma of the duodenum associated with early gastric carcinoma.