腹腔鏡補助下に手術を施行した下行結腸リンパ管腫の1例

A patient with lymphangioma of the descending colon resected by laparoscopic surgery

◆要旨：患者は60歳，女性．下行結腸リンパ管腫の疑いにて当院に紹介された．下部消化管内視鏡検査にて下行結腸脾彎曲近くに粘膜下腫瘍を認め，その内視鏡的特徴からリンパ管腫と診断した．CTにて同部は36mmの囊胞性病変として指摘され，内視鏡的切除は難しく，腹腔鏡補助下結腸部分切除術を施行した．術後病理組織検査では囊胞状リンパ管腫であった．リンパ管腫は悪性化しないと報告されており，小さいものは経過観察あるいは内視鏡的切除が施行されることが多いが，大きくなり臨床症状を呈した場合は外科的切除の適応となる．手術を考慮する場合，低侵襲である腹腔鏡下手術は非常に有用と考えられた．

A 60-year-old female with a tumor of descending colon was referred to our hospital. Colonoscopy revealed submucosal tumor and computed tomography showed a 36mm cystic tumor at the descending colon. The preoperative diagnosis was lymphangioma of the colon. Since endoscopic excision was considered difficult to perform due to the large tumor size, laparoscopy-assisted colectomy was conducted. Histopathological diagnosis was cystic lymphangioma of the colon. Because lymphangioma is a benign tumor with no malignant potential, tumor resection is not necessary. However, endoscopic excision and operation are performed when the tumor becomes large or when the patient has some symptoms and the diagnosis is difficult to make. Since lymphangioma does not contain any malignant component, laparoscopy-assisted colectomy is preferable for the treatment of lymphangioma of the colon due to the minimum surgical invasiveness compared with open colectomy.