Waldeyer輪悪性リンパ腫52症例の治療成績

Therapeutic Results of Patients with Malignant Lymphoma of Waldeyer's Ring

　はじめに

　頭頸部領域は節外性悪性リンパ腫の好発部位の1つである。特に，リンパ組織が集中しているWaldeyer輪は悪性リンパ腫が好発する。悪性リンパ腫はその起源細胞によりB細胞性，T細胞性あるいはNK （ナチュラルキラー）細胞性がある。Waldeyer輪には前者のB細胞性の悪性リンパ腫が多いが，T細胞性のリンパ腫も発症する^1〜3）。また，T細胞性の場合でもHTLV−1（成人T細胞性白血病ウイルス）の関与しないものと，同ウイルスの関与する，いわゆるATLL（adult T-cellleukemia／lymphoma）があるが，その両者がWaldeyer輪には発生する^4,5）。今回われわれは，ATLLを除くWaldeyer輪の悪性リンパ腫について臨床的，統計学的に観察を行った。その結果に若干の考察を加えて報告する。

Fifty-two patients with malignant lymphoma of Waldeyer's ring treated in our hospital between 1975 and 1998 were reviewed. All patients showed nega-tive serological results for human T-cell leukemia virus type I. About 90% of these patients were staged in I and II. The main pathological subtypewas the diffuse large cell type and about 80% of patients were classified into intermediate grade of malignancy. The surface maker of about 80% were B-cell type and others T-cell type immunohisto-chemically. Patients were treated with combination of chemotherapy (CHOP) and radiotherapy. The 5-year survival rate of all 52 patients was 57%, and the patients received scheduled treatment and over 70-year old patients were 81% and 17% respective-ly. The immunohistochemical T-cell type lym-phoma was relatively resistant to chemo-radio-therapy, and 5-year survival rate of T-cell type and B-cell type were 63% and 71% respectively, but there was no statistical significance.