⑧ポリポイド癌に類似した腫瘤形成型早期胃悪性リンパ腫の1例

Malignant Lymphoma of the Stomach Simulating Polypoid Carcinoma

　Ⅰ＋Ⅱa型早期胃癌に類似し，主病変が粘膜層に限局した胃原発性悪性リンパ腫例を経験したので報告する．

　症　例

　患　者：32歳，男，公務員．

　主　訴：空腹時の心窩部痛．

　既往歴，家族歴：特記することはない．

　1978年4月頃から，空腹時に心窩部痛があり，5月末に，他院で上部消化管検査を受け，胃潰瘍の診断で，内科的治療を受けた．その後，3回にわたり内視鏡的に経過が観察され，胃角から幽門洞にみられた潰瘍は漸次縮小したが，周辺粘膜が浮腫状で凹凸不整の隆起があり，生検で悪性リンh腫の疑いをもたれたため，同年12月上旬に，当センターを訪れた．

　A 32 year-old male with an 8-month-history of fasting epigastric pain was referred to our hospital for a suspicion of malignant lymphoma of the stomach, after being treated as the multiple gastric ulcer.

　UGI series and endoscopy showed a large irregular polypoid lesion with multiple ulcerations of proximal antrum to angulus, which was histologically confirmed to be malignant lymphoma on biopsy specimens.

　Partial gastrectomy and splenectomy were performed.

　Resected specimen of the stomach demonstrated a large polypoid tumor associated with small nodules at the surrounding mucosa, simulating type Ⅰ+Ⅱa of early gastric carcinoma.

　Histologically, it was classified as malignant lymphoma, large cell type, diffuse. The depth of invasion was mostly limited within the mucosal layer. No lymph node metastasis was noted.