⑦典型的Borrmann1型を呈した胃悪性リンパ腫の1例

A Large Polypoid Malignant Lymphoma

　胃X線および内視鏡検査にて，Borrmann1型の胃癌が疑われ，胃生検で，悪性リンパ腫の診断が得られた1症例を報告する．

　症　例

　患　者：MY，51歳，男．

　主　訴：心窩部痛．

　既往歴：1963年，痔核手術のあと輸血後肝炎．

　家族歴：特記すべきものなし．

　現病歴：1979年夏頃より空腹時心窩部痛出現．人間ドックにて，胃X線検査上異常陰影を指摘され，7月17日入院．

　A 51 year-old man had suffered from epigastric pain. X-ray and endoscopic examinations revealed a large polypoid lesion with irregular surface and shallow ulceration on the middle portion of the body along the greater curvature site. He was diagnosed clinically as having a typical Borrmann 1 type cancer of the stomach. Biopsy materials were taken from the tumor and histologically diagnosed as malignant lymphoma.

　In the resected stomach, there was a large polypoid tumor mass located in the gastric body through the greater curvature site, measuring approximately 5.5×4.5×4.5 cm.

　According to Rappaport's classification, this case was histologically classified into malignant lymphoma, poorly differentiated lymphocytic type.

　Tumor cell infiltration was limited to the submucosa, but intramucosal spread of the tumor was very extensive. Therefore, this tumor belongs macroscopically to Borrmann 1+Ⅱb, according to the macroscopic classification of gastric cancer. Nine regional lymph nodes were free of malignancy.