悪性リンパ腫との鑑別を要した胃梅毒の1例

Gastric Syphilis Similar to Malignant Lymphoma, Report of a Case

要旨●患者は50歳代，男性．20XX年8月より心窩部痛，嘔気，体重減少が出現し，当院へ紹介となった．上部消化管X線造影検査では前庭部から胃体部に辺縁の毛羽立ちと粗糙な粘膜像を認め，EGDでは前庭部から胃体部に不整形のびらんや潰瘍が多発していた．当初は胃MALTリンパ腫を疑ったが，風俗店の利用歴と梅毒血清反応陽性であったため胃生検組織の抗T. pallidum抗体染色を行い，胃梅毒と診断した．ペニシリン，アモキシシリンによる駆梅療法を行った結果，速やかに軽快した．近年，梅毒感染症の増加が報告されており，消化器領域の日常診療でも胃梅毒に注意すべきである．

　A male patient in his 50s was referred to our hospital due to stomach pain, nausea, and weight loss. Upper gastrointestinal radiography revealed a shaggy appearance and rough-surfaced mucosa in the gastric antrum and body, and upper gastrointestinal endoscopy detected multiple irregular erosions and ulcers. Initially, gastric mucosa-associated lymphoid tissue lymphoma was suspected. However, a sexually transmitted disease was suspected based on the patient's history. With a positive serum syphilis test, and anti- Treponema pallidum antibody staining of the gastric biopsy tissue, the patient was diagnosed with gastric syphilis. Penicillin and amoxicillin were then administered. Given that the number of patients diagnosed with syphilis has been recently increasing, this disease should be considered in the daily medical care in the gastroenterology department when irregular erosions are observed in the gastric antrum.