⑩表層拡大型＋腫瘤形成型を呈した胃原発性リンパ肉腫の1例

Primary Gastric Lymphosarcoma Showing Mixed Findings of Superficial Spreading Form and Protruded Form

患　者：39歳，男．

主　訴：心窩部痛．

家族歴，既往歴：特記すべきことなし．

現病歴：数年前より，上腹部不快感あるもそのつど健胃散の服用により，不快感は軽快していた．1カ月前より，時々，心窩部痛を訴えるようになり，外来受診し，胃X線，内視鏡検査の結果，入院となる．

　A 39 year-old man was admitted to our hospital with complaint of epigastric pain which had appeared since one month before. On admission, he complained of tenderness in the epigastrium. In laboratory findings, the feces was positive for occult blood. Bariumfilled radiograph of the stomach in upright position revealed irregularity and rigidity on the greater curvature from the angular region to the corpus, but showed flexibility in the gastric wall of the lesion. In supine double contrast pictures, shallow-depressed lesion with obscure margin was demonstrated on the posterior wall and the greater curvature of the corpus. In prone double contrast pictures, Ⅱa-like lesion was revealed on the anterior wall of the angle. Endoscopic examination showed protruded lesion with white coat and bleeding on the anterior wall of the angle and Ⅱc-like lesion in the area from the anterior wall to the greater curvature of the corpus. No wormeating or fusion at the tips of the converging mucosal folds were discovered, and luster in the depressed area of the Ⅱc-like lesion was recognized. Resected stomach revealed various types of lesion with a size of 90×100 mm at the posterior wall and the greater curvature ranging from the angle to the corpus. Histological study of the resected stomach showed lymphosarcoma originating from the stomach.