腹壁皮下脂肪織内に原発したびまん性大細胞型B細胞リンパ腫の1例

A case of primary diffuse large B-cell lymphoma in the subcutaneous adipose tissue of the abdominal wall

びまん性大細胞型B細胞リンパ腫（diffuse large B-cell lymphoma：DLBCL）は日本では全リンパ腫のうちの約30％を占めており^1）2），非ホジキンリンパ腫では最も多い造血器腫瘍である^1）。DLBCLの節外性病変は全身に発生し得るが^3）4），皮下脂肪織内に原発する悪性リンパ腫はまれであり^5），報告も数例しかされていない。今回我々は，腹壁の皮下腫瘤で発見されたDLBCLを経験したので報告する。

We report a rare case of primary subcutaneous diffuse large B-cell lymphoma（DLBCL）. A female in her 90s presented with a subcutaneous mass into the abdominal wall. CT suggested a 27 mm subcutaneous tumor, and MRI revealed marked diffusion restriction and with rapid growth to 45 mm over 27 days. The patient underwent a radical resection. The tumor was pathologically diagnosed as a DLBCL. Primary subcutaneous DLBCL is extremely rare. Previous cases have shown that subcutaneous DLBCL proliferates rapidly, producing significant sized tumors in a few months. In addition to soft tissue malignant tumors such as sarcomas, malignant lymphoma should be considered as a differential diagnosis for rapidly enlarging tumors in the subcutaneous adipose tissue.