眼窩内に再発したマントル細胞リンパ腫の1例

A case of mantle cell lymphoma with recurrence in the orbit

要約　背景：マントル細胞リンパ腫（MCL）は悪性度は低いが，治療に抵抗し，予後不良とされ，標準的な治療も確立していない。目的：眼窩に再発したMCLの症例の報告。症例：72歳男性が右眼瞼腫脹で受診した。31か月前に右腋窩リンパ節生検でMCLと診断され，消化管と骨髄に浸潤があった。R-CHOP療法で寛解した。所見：右上球結膜下に径3cmの腫瘤があり，後頸部や前胸部にも皮下腫瘤があった。複数箇所の生検を行い，免疫組織染色と遺伝子解析でMCLの診断が確定した。リツキシマブを含むR-DeVEC療法で腫瘍は縮小したが，初診の10か月後に両側の眼窩に再発した。放射線療法で腫瘍は消失し，再発から4か月後の現在，治癒した状態にある。結論：MCLの本症例では，2回の化学療法と放射線療法で寛解が得られた。

Abstract.　Background：Mantle cell lymphoma（MCL）is categorized as low-malignant tumor with poor prognosis due to resistance to treatments. Purpose：To report a case of MCL with orbital involvement. Case：A 72-year-old male presented with swelling of right upper eyelid. He had been diagnosed with MCL after biopsy of axial lymph node. Metastasis was present in the intestinal tract and bone marrow. Systemic treatment with R-CHOP was followed by remission. Findings：A spherical tumor was present in the right upper eyelid. Subcutaneous tumors were also present in the chest and neck. After biopsy,the tumors were identified as MCL by immunofluorescence study and gene analysis. The tumor decreased in size after systemic treatment with R-DeVEC but recurred in both orbits 10 months after his initial visit. Orbital tumor disappeared after radiotherapy. The patient is doing well for 4 months after orbital recurrence. Conclusion：MCL in this patient was brought under control following 2 sessions of chemotherapy and radiation.