胃原発性ポジキン病の1例

A Case of Primary Hodgkin's Disease of the Stomach

　1832年，Hodgkin¹⁾により報告され，後，Wilks²⁾がポジキン病と名づけた発熱，リンパ腺腫，貧血脾腫をともない悪液質におちいって死の転帰をとる疾患は，特殊性炎症性腫瘍とするもの，腫瘍とするものがあり，全身リンパ腺ないしリンパ系を系統的に侵すもので，胃に原発することは，稀とされている．

　筆者らは最近，胃原発性ポジキン病の1例を経験したので報告する．

　A study has been made of a case of primary Hodgkin's disease recently encountered in a 19-yearold female who was complaining of pain in the epigastrium.

　In the spring of 1968, the patient had noticed epigastric pain of short duration. It recurred in May 197o, associated with anorexia and fever. At first admitted to Iwate Prefectural Fukuoka Hospital, she was referred for evaluation to the out-patient clinic of Kaito Department of Internal Medicine, Iwate Medical University.

　Lymph node, liver or spleen was not palpated. In the general examinations there was no trace of anemia, and blood pictures including differential count of leucocytes remained within normal limits.

　X-ray study of the stomach revealed many irregular shadow flecks, extending over a wide area from the lower corpus down to the lesser curvature of the antrum, associated with mucosal convergence.

　Endoscopy also disclosed on the same sites as visualized by x-ray irregular-shaped ulcer and erosions of various size. The mucosa around the ulcer was elevated with partial nodular mucosal folds.

　By cytology it was diagnosed as belonging to Class Ⅳ.

　Evaluation of these findings led the authors to suspect the existence of either gastric cancer or sarcoma, so that gastrectomy was performed. On histological study of the resected stomach, nests of infiltration comprised of lymphocytes, Hodgkin cells and Reed-Sternberg giant cells were recognized chiefly in the mucosa with partial involvement of the submucosa. The whole picture proved to be a case of primary Hodgkin's disease of the stomach, otherwise to be called early sarcoma of the stomach.