下眼瞼腫脹を主訴に発見された涙囊部原発T細胞悪性リンパ腫の1例

Swelling of the lower eyelid as the initial manifestation of primary T cell malignant lymphoma of the lacrimal sac

要約　54歳女性が1か月前からの左下眼瞼腫脹で受診した。左涙囊部に弾性硬の腫瘤があり，涙囊造影で涙囊が腫瘍により外側に圧排されていた。生検を行い，免疫組織学的検査にてT細胞型のびまん性中細胞性悪性リンパ腫，peripheral T-cell lymphomas unspecifiedと診断された。全身検索にて他の臓器に病変を認めず，病期はAnn-Arbor分類Stage IEであった。放射線療法（39.6 Gy），化学療法（CHOP 3コース）を施行し，腫瘍は消失した。生検から16か月後の現在まで再発や転移はない。本症例は，涙囊部原発のT細胞悪性リンパ腫の初報告例である。

Abstract.　A 54-year-old woman was referred with 1-month history of swelling of left lower lid. Palpation showed a hard elastic tumor around the left lacrimal lesion. Dacryocystography revealed the lacrimal sac dislocated laterally by a tumor. Biopsy led to the diagnosis of diffuse medium-sized malignant lymphoma. Immunochemistry showed the lymphoma to be T cell type,peripheral T-cell lymphomas unspecified. No systemic metastasis was detected. The patient was classified as StageIE according to the Ann Arbor staging system. She was successfully treated with radiation therapy（39.6 Gy）and chemotherapy（3 cycles of CHOP）. For 16month after biopsy,she has been free from recurrence and metastasis. This is the first reported case of primary T cell malignant lymphoma of the lacrimal sac.