胃の原発性形質細胞腫の1治験例

A Case of Primary Gastric Plasmacytoma

　髄外性形質細胞腫の中で，胃の原発性形質細胞腫はきわめて稀であり，Vasiliuの第1例目の報告¹⁶⁾以来，内外で約49例，本邦においては，伝田ら²⁾以来6例の報告があるにすぎない．われわれは今回，それぞれ第50例目，第7例目と思われる症例を経験した．この症例は悪性のものと判断されたにもかかわらず，再発の徴なく術後10年6カ月を経過しており，このような長期生存例の報告は他にみられないので，ここに報告し，あわせて多少の文献的考察を加える．

　A case of primary gastric plasmacytoma is presented, developing progressive weight loss, anorexia, diarrhea and edema of both lower extremities. Through roentgenographic and endoscopic examinations, the gastric tumor was first diagnosed as carcinoma. At the operation, the large mass which appeared grossly to be of Borrmann-2 type was located at the greater curvature of the antrum of the stomach, and neither metastasis to regional lymphnodes nor extension to the other organs was recognized. Then, it was completely extirpated by distal partial gastrectomy.

　Histologically, the tumor consisted of diffuse proliferation of atypical plasma cells with marked anisocytosis, pleomorphism and atypical mitosis, infiltrating into the subserosal layer. According to these findings, this tumor was confirmed to be a primary malignant plasmacytoma of the stomach.

　This case is probably 50th case (the first report was made by Vasiliu in 1928) in the literature of the world, and 7th case (the first was made by Denda in 1965) in our country. This patient is alive and no recurrence has been noticed 10.5 years after the operation. Such a long surviving case has rarely been reported to our knowledge.