腸管悪性リンパ腫の臨床病理学的検討

Clinicopathological Study on Primary Intestinal Lymphoma

要旨　外科的に切除された腸管原発悪性リンパ腫24例について，臨床病理学的検討を行った．早期リンパ腫と進行リンパ腫に分けられ，前者の肉眼型は，早期胃癌の肉眼型分類に準じて分類することが可能であった．後者のそれは，（1）polypoid type，（2）diffusely infiltrating type，（3）ulcerative type，（4）early lymphoma-like typeの4型に分類できた．polypoid typeは大腸に好発し，組織学的には小細胞型および中細胞型が多く（6/11例），悪性度が低い傾向があり，ulcerative typeは小腸に好発し，多発傾向があり，組織学的には大細胞型が多く，多形型もみられ（4/8例），悪性度が高い傾向があることが特徴的であった．

　Clinicopathological study was undertaken regarding 24 cases of primary intestinal lymphoma (IL) diagnosed on surgically resected materials (male 14, female 10, mean age 58 years old). We separated the lesions into early type, i.e., the lesions limited to the submucosal layer, and advanced type, i.e., the lesions which penetrated the proper muscle layer. Gross classification of the former was based on the general rules for the gastric cancer study, and the latter was further divided into the followings; (1) polypoid type (11 cases), (2) diffusely infiltrating type (3 cases), (3) ulcerative type (8 cases), and (4) early lymphoma-like type (1 case). There were 5 cases of early lymphomas, four of which were associated with advanced lymphomas. Most of the polypoid type occurred in the large intestine with histological tendency of low grade malignancy. All of ulcerative type, on the other hand, arose in the small intestine with histological tendency of high grade malignancy.