胃前庭部の高度な狭窄を示したRLHの1例

Reactive Lymphoreticular Hyperplasia with Remarkable Narrowing of the Antrum, Report of a Case

　近年，Reactive Lymphoreticular Hyperplasia（以下RLHと略す）に関する報告例が多数発表され，その分類も中村ら¹⁾²⁾，勝又ら³⁾⁴⁾によってなされている．最近，われわれは前庭部に高度の狭窄を示し，組織学的にRLHと診断された1症例を経験した．本症例は中村，勝又らのRLHの分類のいずれにも属さず特異な形態を示しているので報告する．

　A 78-year-old man had epigastric distress since 1973, and gastrocamera was performed in 1973 and 1975.

　X-ray picture performed in 1980 disclosed two niches on the angulus without malignant findings and remarkable narrowing of the antrum, which was uncertain in nature.

　Gastrocamera studies without biopsy performed in 1973 and 1975 showed benign ulcers on the angulus. Gastrofiberscopic findings in 1980 revealed two peptic ulcers and narrowing of the antrum with some erosions. But precise observation on the antrum was impossible because of tunnel formation. Biopsy specimens of the ulcers and the erosions of the antrum were classified into group II.

　The surgically resected specimen showed two ulcers on the angulus and remarkable thickness (1.5 cm) of the antrum wall, which was pale, yellow.

　Histopathologically, peptic ulcers were ulcus-IV, and growth of lymph follicles was found mainly in the muscle layer and the subserosa ann scarcely in the propria mucosa and the submucosa in the antrum to the oral side of the ulcers. Therefore the lesion was diagnosed as RLH due to the peptic ulcers on the angulus.

　Thickness of the muscle layer of the antrum due to RLH was a first report in Japanese literature.