硬膜に発生したextranodal marginal zone lymphomaの1例

Extranodal Marginal Zone Lymphoma of the Dura: A Case Report

Ⅰ．はじめに

　局所に長くとどまる傾向にあり，しかも長期生存が期待できるextranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue-type lymphoma（MALT lymphoma）は，IsaacsonとWrightが1983年に発表して以来，これまでさまざまな臓器で報告されてきた⁵⁾．われわれは左片麻痺で発症し，画像診断では髄膜腫様の所見を示し，手術により硬膜腫瘍を呈し，病理学的にprimary central nervous system（CNS）diffuse large B-cell lymphomaと診断されたにもかかわらず，その後9年以上生存した症例を経験していた．この症例を長期生存の悪性リンパ腫の観点から病理学的に検討しなおし，primary MALT lymphoma of the dura（dural MALT lymphoma）と診断されたため，稀な疾患と考え，文献的考察を加えて報告する．

　The authors present the case of a 65-year-old woman who initially was diagnosed as having intracranial dural B-cell malignant lymphoma. She survived more than 9 years after surgery and radiation. We re-examined the specimens pathologically. Histological findings confirmed an extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) that showed numerous IgG4-positive plasma cells. MALT lymphomas are already recognized as a distinct clinico-pathological entity. A primary dural MALT lymphoma is very rare and has a favorable clinical outcome, and patients are expected to have an excellent long-term survival with local therapy alone.