表在型胃悪性リンパ腫の鑑別診断―超音波内視鏡診断

Differential Diagnosis of the Superficial Type Gastric Malignant Lymphoma: Endoscopic Ultrasonographic Diagnosis

要旨　早期胃癌140例144病変，悪性リンパ腫13例26病変，うち表在型リンパ腫10病変に対して超音波内視鏡像の特徴を検討した．早期胃癌は病変部のエコーが均一と不均一な病変がほぼ同数で，第3層と第4層の間のエコー輝度を呈する病変が多く認められた．また，病変の境界が鮮明と不鮮明な病変もほぼ同数認められた．境界不鮮明な例は癌巣内潰瘍の合併率が多く認められた．悪性リンパ腫は内部エコーの均一な例が多く，境界明瞭で，第4層のエコー輝度に類似する病変が多く認められた．表在型悪性リンパ腫では第3層と第4層の間のエコー輝度を呈する例がやや多く，内部エコーが不均一な例が多くみられた．

　Endoscopic ultrasonographic findings of the 144 lesions of 140 cases of early gastric cancer, 26 lesions of 13 cases of malignant lymphoma which included 10 lesions of superficial type lymphoma were analyzed. In the group of early gastric cancer, almost half of the lesions had uniform echo but the rest had heterogeneous echo, and many lesions had the same echo intensity between the third and fourth layers. A half of the lesions had clear demarcation between a lesion and normal area, and the remaining half of the lesions had unclear demarcation. The lesion with unclear demarcation might be associated with an ulcerative lesion in the cancerous tissue. In the malignant lymphoma group, most of the lesions had uniform echo with clear demarcation, and many lesions had the similar echo intensity of the fourth layer. In the superficial malignant lymphoma group, more than half of the lesions had the same echo intensity between the third and fourth layers, and many of them had heterogeneous echo inside.