②原発性胃Hodgkin病の1例

Hodgkin's Disease of the Stomach

　胃に原発する悪性腫瘍のうち，非上皮性腫瘍の占める割合は0.5～1.7％といわれている．

　大井ら¹⁾の全国集計によると，胃肉腫のうち悪性リンパ腫は約70％を占めているが，Hodgkin病は3.1％にすぎず，非常にまれである．胃腸管に発生するHodgkin病は，1913年Schlagenhaufer²⁾が報告したのに始まり，外国では比較的報告例が多いが，本邦では1924年の大沼³⁾による胃腸原発症例の報告以来，われわれの集計しえた範囲では63例で，その病理組織学的混乱を考慮に入れても，まだ本邦ではまれな症例といってよいだろう．

　The patient, 69 year-old man, had an episode of epigastralgia 5 years before operation. At that time, radiologic and endoscopic examinations were essentially within normal limits. Epigastralgia occurred again. Then, the radiological examination of the upper gastrointestinal tract revealed a man's fist-sized tumor shadow in the fornix of the stomach, in which contraction of the stomach wall was not observed. Endoscopic examination disclosed a protruded lesion with a center of large ulceration. Biopsy materials endoscopically taken from the tumor diagnosed as malignant lymphoma histologically. Total gastrectomy was performed.

　In the resected stomach, there was a protruded tumor of the fornix with ulcerations, measuring approximately 85×75 mm, which was relatively welldemarcated. The tumor cells infiltrated into the serosa and 4 out of 25 regional lymph nodes were involved. According to Rye's classification of Hodgkin's disease, the tumor belongs histologically to lymphocytic depletion type.