胃granular cell tumor（顆粒細胞腫）の1例

Granular Cell Tumor of the Stomach, Report of a Case

要旨　granular cell tumorは皮膚，舌，乳腺などに多くみられる腫瘍であり，消化管に発生する例は少なく，特に胃ではまれである．筆者らは胃に発生したgranular cell tumorの1例を経験したので報告する．患者は51歳の男性．吐血を主訴として来院．X線・内視鏡検査で胃体中部後壁に，頂上に小潰瘍を有する粘膜下腫瘍を認めた．超音波内視鏡検査では腫瘍は第3層に限局して存在する低エコーの腫瘤として描出された．切除胃標本では，腫瘍は大きさ20×18×16mmで粘膜下層内に限局して存在する白色調の腫瘍であり，病理組織学的にgranular cell tumorと診断された．

　A 51-year-old man visited our hospital in June, 1985, because of hematemesis. Upper gastrointestinal endoscopic examination showed a protruding and semispherical lesion with clear boundary and smooth surface in the posterior wall of the middle body of the stomach. There was, however, no bleeding. A small ulcer was observed at the center of the lesion. Since nausea, fatigue and anorexia continued, he was admitted to the hospital on July 10. Upper gastrointestinal x-ray examination demonstrated the protruding lesion with a small depression in the middle body of the stomach. The lesion was accompanied by bridging folds. Subsequently performed endoscopic ultrasonography showed a mass, 2 cm in size, clearly demarcated and with low echoic homogeneous contents in the 3rd layer. The 4th layer was intact. Based on these findings the mass was diagnosed as submucosal tumor. Considering a possibility of malignancy, gastrectomy was performed. The tumor measuring 20×18×16 mm in size was yellowish-white. Histologically it was granular cell tumor. Postoperative course was uneventful and he was discharged on August 28.

　The granular cell tumor rarely occurs in the gastrointestinal tract, especially in the stomach. As far as we know, this is the 8th case in Japan. All these cases reported were non-malignant.