短期間に著明な形態変化がみられた胃悪性リンパ腫（T細胞性）の1例

Malignant Lymphoma Showing Marked Alterations of the Lesion in a Short Period

　短期間に著明な形態的変化がみられた胃悪性リンパ腫を経験したので報告する．

症　例

　患　者：55歳，男．

　主　訴：心窩部痛．

　家族歴：特記すべきことなし．

　既往歴：結核性胸膜炎，腹膜炎（19歳）．胆石症（39歳，胆のう切除術施行）．

　現病歴：1979年9月中旬より心窩部痛出現，食事とは無関係で，飲酒後の早期に強い．体重減少も出現し近医受診，胃X線検査にて異常を指摘され，10月13日当科紹介となる．

　A 55-year-old male patient was admitted to our hospital on October 13,1979 with chief complaint of epigastric pain.

　The endoscopic findings (October 13, 1979) on admission were sufficient enough to make diagnosis of malignant lymphoma. The second x-ray (November 15, 1979) and endoscopic (November 17, 1979) findings performed 36 days after the first endoscopic findings revealed a marked alteration of the gastric lesions. Supine double contrast film demonstrates a large irregular niche and a marked surrounding translucency which reveals prominently elevated margin on the lesser curvature of the under portion of cardia. Endoscopic examination showed two protruded lesions with a wide white-coated central depression on the lesser curvature of the under portion of corpus and on the cardia.

　The resected stomach revealed two protruded lesions with a large ulceration at the lesser curvature of the corpus. The two protruded lesions were found to be one lesion in its extent of tumor cell infiltration, measuring 85×75 mm.

　The histological diagnosis was malignant lymphoma (diffuse, mixed cell type) without lymph node metastasis. Histologically, tumor cells infiltrated mostly in submucosa of the stomach and invaded in the proper muscle layer in a part.

　The study of the surface markers of lymphocytes of this lymphoma disclosed a T cell origin of this lymphocytes by means of the immunofluorecent staining with anti-human T cell serum.