小腸原発Burkittリンパ腫の1例

Burkitt's Lymphoma of the Small In testine, Report of a Case

要旨　患者は25歳，女性．下腹部膨満にて近医を受診，同部に腫瘤を指摘され当院に紹介入院．下腹部に小児頭大の腫瘤を触知し，小腸X線検査で腫瘤部に一致して空腸に約10cmにわたる全周性潰瘍を認めた．腹部超音波・CTでは壁が著明に肥厚し，管腔の拡張した腸管像として認められた．小腸原発悪性リンパ腫と診断し手術を施行，空腸病変部と浸潤のみられたS状結腸および腫大した両側卵巣を切除した．病理組織像ではびまん性に増殖したリンパ芽球様腫瘍細胞の間に食食細胞が散在するstarry sky像を呈し，Burkittリンパ腫と診断した．

　A 25-year-old woman was admitted to our hospital because of a lower abdominal mass. Radiologic examination of the small intestine revealed a circumferential irregular ulcer of the jejunum. Abdominal ultrasonography and CT scan showed a large solid mass in the pelvis. Partial resection of the jejunum and resection of the sigmoid colon and ovaries, which were involved by the tumor, were performed. Histologically the tumor showed a “starry sky” pattern with the macrophages interspersed among undifferentiated lymphoblastoid cells. Considering the clinical aspects and the histological findings, we diagnosed the tumor as Burkitt's lymphoma.