空腸リンパ管腫の1例

Jejunal Lymphangioma, Report of a Case

要旨　小腸X線検査にて，術前に存在診断ができた空腸リンパ管腫を経験した．患者は62歳男性．主訴は労作時の動悸で，一般検査で高度貧血と便潜血反応強陽性を認め，消化管出血を疑った．上部消化管と大腸の精査では異常なく，小腸X線検査を施行した．空腸に山田Ⅱ型ポリープ様病変を認め摘出手術を施行した．腫瘤は，Treitz's靱帯より50cmの空腸腸間膜付着部対側に認められ，大きさ12×12×4mmの粘膜下腫瘍で，病理組織学的には海綿状リンパ管腫であった．小腸リンパ管腫は非常にまれで，術前にX線学的に詳細に検討されたものは見当たらない．

　A 62 year-old man was admitted to our hospital complaining of palpitation. As physical examination and laboratory data showed seriousa anemia and occult blood test (3+), we suspected that he might have gastrointestinal hemorrhage. Neither x-ray examination of the upper gastrointestinal and lower gastrointestinal series nor endoscopy of them disclosed any abnormalities.

　X-ray examination of the small intestine revealed a small tumor in the jejunum which was probablly considered to be a submucosal tumor with bridging fold. Partial resection of the jejunum was performed. The submucosal tumor was seen in the antimesenteric area 50 cm apart from Treitz's ligament, measuring 12×12×4mm. Histopathologically it was diagnosed as cavernous lymphangioma. Lymphangioma in the small intestine is a rare disease, and only ten cases have been reported in the last ten years in Japan.