④多発の胃悪性リンパ腫の1例

Multiple Malignant Lymphoma of the Stomach

　肉眼的に胃体部大彎を中心に周堤をもつ多発の陥凹性変化を認め，組織学的に粘膜固有層から漿膜下層に達する多発の胃原発性細網肉腫を経験したので報告する．

　症　例

　患　者：佐○乙○，52歳，男．

　主　訴：心窩部痛．

　既往歴：1959年肺結核．1969年急性肝炎．1967年より気管支喘息にて治療中．（現在Predonin 5mg/day服用中）

　家族歴：父・甥　白血病．

　現病歴：1972年7月より心窩部痛が出現し，近医にて胃X線検査を受けるも異常なしと言われた．その後疼痛が増強するため，同年9月に胃X線・内視鏡検査を受け精査のため入院となる．

　The following is a summary of the x-ray and endoscopic findings of the stomach of a 52 year-old man with epigastric pain :

　1. Multiple masses were found on the greater curvature of the gastric body and fornix. Almost all of the masses were occupied by deep irregular depressions with smooth elevated margin and were sharply circumscribed. In a few of them, however, saucer-like appearance was revealed.

　2. Each lesion exists independently. Thus the origin of malignant lymphoma may be multicentric in this case.

　3. Peptic ulcerations with converging folds were found among the lesions.

　This case was easily diagnosed as malignant lymphoma of the stomach from these results. The pathological diagnosis was reticulum cell sarcoma without lymph node metastasis and multiple benign ulcers. Histologically, tumor cells infiltrated to the subserosal layer of the stomach.