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Stomach and Intestine(Tokyo) Volume 12, Issue 2 （February 1977）

胃と腸 12巻2号（1977年2月発行）

Japanese English

症例

著明な変化を来した興味ある胃潰瘍瘢痕の1例―特に胃悪性リンパ腫と鑑別困難であった症例 A Case of Ulcer Scar of the Stomach 天野育造 ¹ , 江村武志 ¹ , 安元真武 ¹ , 今村賢一郎 ¹ , 沢田征洋 ¹ , 池田健吾 ¹ , 占部一喜 ¹ , 二宮健 ¹ , 沢田一彦 ¹ , 日高覚 ¹ , 樺木野修郎 ² I. Amano ¹ , T. Emura ¹ , M. Yasumoto ¹ , K. Imamura ¹ , M. Sawada ¹ , S. Kabakino ² ¹久留米大学医学部第2内科 ²福岡歯科大学外科 ¹Second Department of Internal Medicine, Medical Faculty of Kurume University ²Department of Surgery, Fukuoka Dental College pp.241-246

発行日 1977年2月25日 Published Date 1977/2/25

DOI https://doi.org/10.11477/mf.1403112507

PDF(4806KB)

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Abstract 文献概要
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　短期間で胃X線・内視鏡所見に著明な変化を呈し，臨床的には胃悪性リンパ腫を疑い，切除胃の組織学的検索では単なる胃潰瘍瘢痕であった興味ある症例を経験したので報告する．

　The case is that of a 49-year-old female who showed a depressed lesion of the gastric antrum on the posterior wall associated with marginal elevation on the initial roentgenographic examination. The depressed area was also nodulated. No redness or bleeding was present on the endoscopic examination. Malignant lymphoma was clinically considered. Endoscopic biopsy disclosed hyperplasia of the lymphoreticular cells in the tissue, but no definitive malignancy was ascertained.

　The second roentgenography performed 60 days later revealed a depressed lesion with mucosal convergence running from the lesser curvature of the antrum. Taper folds at the apices were observed. Endoscopy at that time demonstrated a depressed lesion with white coating and edematous margin. Histology of the second biopsy resembled that of first one.

　Roentgenographic and endoscopic findings were very different between the first and the second examinations. Because of few findings suggesting a benignity and of histologically non-epithelial lesion, subsequent gastrectomy was performed under a clinical diagnosis of malignant lymphoma.

　An ulcer scar was grossly found in the stomach resected 96 days after the first roentgenography. Histopathology disclosed only an ulcer-scar (Ul-Ⅱ) but no evidence of lymphoreticular hyperplasia as seen in the biopsies.

　Cases of reactive lymphoid hyperplasia (RLH) have been clinically diagnosed as cancer on many occasions in the review of literature. Histological diagnosis of RLH is not always easy. Proliferation of lymphoreticular cells may be secondary to benign ulcer, inflammatory lesion, even to carcinoma or sarcoma, and it is not concluded that it represents an entity.

　For clinical diagnosis of RLH, careful follow-up observations are indicated. By the establishment of diagnostic criteria for gastric reticulum cell sarcoma of early stage, clinical diagnosis of RLH may become possible to some extent.