顆粒細胞性筋芽腫と胃神経鞘腫との重複の1例

A CASE OF GRANULAR CELL MYOBLASTOMA COEXISTENT WITH NEURINOMA

Ⅰ．まえおき

　顆粒細胞性筋芽腫（Granular cell myoblastoma）は1926年Abrikossoff¹⁾がはじめて特有な顆粒を細胞質内に有する筋原性の良性腫瘍として記載した．本腫瘍は，主として皮膚および舌に発見される．欧米では多くの研究があり，また発生起原も種々探究されているが，本邦での報告例は極めて少ない．また胃神経鞘腫（Neurinoma）は1910年Verocay²⁾らがその本態を究明したが，本邦でも少なからず報告されている．本腫瘍は粘膜下または漿膜下に生ずる神経原性の良性腫瘍で，必ずしもまれではない，われわれは最近術後の組織学的検索で，胃粘膜下に顆粒細胞性筋芽腫が存在し，さらに漿膜下に神経鞘腫が重複していた1例を経験した．このような重複良性腫瘍は珍らしいので，文献学的考察を加えて報告する．

　This is a report of granular cell myoblastoma with concomitant neurinoma found and confirmed in the same stomach. Some comments thereon are added.

　The patient is a 62 years old female, complaining of pain in the epigastrium and loss of appetite. Physical examination revealed no abnormality, except slight anemia. At X-ray examination, irregularity of mucosal relief was observed in the gastric body, while endoscopically, round, pea-sized protrusion was seen in the same region, suggestive of a solitary, broad-based polyp. Operation was accordingly done by B Ⅱ method. A tumor was found in the resected specimen, measuring 10 by 11 mm, in the submucosa on the anterior wall of the gastric corpus. Histologically this proved to be granular cell myoblastorna. There was also found a smaller tumor in the greater curvature side of the corpus. It was confirmed as neurinoma pathohistologically.

　Predilection site of granular cell myoblastoma is chiefly in the tongue, and it is elsewhere seen in such parts as the skin, subcutaneous layer, larynx, muscle, respiratory organ and the genitourinary system. Its existence in the stomach has been up to now reported only in one instance by Stout. This tumor is generally considered as neoplastic proliferation of degenerated periphery nerve.

　The case reported in this article refers to two co-existent tumors of neurogenous origin, each of different histological etiology.