腸リンパ管拡張症の1例─十二指腸病変を中心に

Intestinal Lymphangiectasia, Report of a Case

要旨●患者は50歳代，男性．下肢浮腫を主訴に近医を受診し，血液検査で低蛋白血症を認め，各種検査で原因不明のため当科に紹介となった．上部消化管内視鏡検査とダブルバルーン小腸内視鏡検査で十二指腸下行部から空腸にびまん性に白色絨毛，散布性白点を認めた．生検病理組織像で著明なリンパ管拡張を認め，腸リンパ管拡張症と診断した．内視鏡観察時に絨毛から乳びの漏出を認め，リンパ漏出を直接確認することができ，他の内視鏡像と合わせて，腸リンパ管拡張症の診断に有用な所見として考えられる．

　A 50-year-old man with leg edema and hypoproteinemia of unknown origin was referred to our hospital. He underwent esophagogastroduodenoscopy and antegrade double-balloon enteroscopy, which revealed diffuse white villi and white spots from the second portion of the duodenum to the jejunum. The biopsy specimens showed a pathological finding of significantly dilated lymphatics. He was diagnosed with intestinal lymphangiectasia endoscopically and histologically. Enteroscopy showed dynamic chyle leakage in the small intestine.