内視鏡的にアメーバ赤痢が疑われ，生検で悪性リンパ腫と確診された1例

Malignant Lymphoma Diagnosed as Amoebic Colitis by Colonofiberscopy, Report of a Case

はじめに

　内視鏡的にアメーバ赤痢が疑われ，生検で悪性リンパ腫と確診された1例について報告する.

　A 73 year-old man was admitted to our hospital with complaints of abdominal pain and bloody stool. He had never been abroad. Laboratory findings showed slight anemia, increased serum amylase and raised erythrocyte sedimentation rate.

　Double contrast radiograph showed multiple tiny barium flecks surrounded by slight elevation in the sigmoid colon through the ascending colon.

　Colonofiberscopy revealed irregularly margined ulcers with white coat surrounded by slight elevation in the rectum, multiple tiny ulcers in the sigmoid colon and multiple variolifQrm erosions in the descending colon, Based on these radiologic and endoscopic findings, the patient was tentatively diagnosed as having amoebic colitis.

　Histological findings, however, showed starry sky phenomena rendering the definitive evidence to diagnose B cell lymphoma.

　Upper gastrointestinal studies were helpful in further estabhshing the diagnosis, malignant lylnphoma, whereas computed tomography, ultrasonography or gallium scintigram did not demonstrate extragastrointestinal involvement.

　The final diagnosis in this patient was malignant lymphoma at stage IV.