回盲部悪性リンパ腫の1例

A Case of Malignant Lymphoma of the Ileo-cecal Region

　われわれは，注腸X線検査によって回盲部癌と診断し，ファイバーコロノスコーピーによる生検で術前にmalignant lymphomaと確診しえた症例を経験したので報告する．

症例

　患　者：55歳，女性．

　主　訴：右下腹部痛．

　家族歴：特記すべきことなし．

　既往歴：1952年，虫垂切除．

　現病歴：1972年8月下旬より右下腹部に鈍痛出現．とう痛は持続性で排便とは無関係であった．同時期に下痢が出現した．

　A fifty-five-year-old female patient was admitted to the Dept. of Int. Med. Cancer Institute Hospital with the chief complaints of the right lower abdominal pain and diarrhea which appeared intermittentl y since the end of August, 1972. Double contrast radiography of the colon revealed a tumor shadow of the ileo-cecal region, which involved the terminal ileum. No abnormality was seen in the x-ray finding of the esophagus, stomach, duodenum and jejunum. Fibercolonoscopy was performed two times and biopsy was done. In the first biopsy, no malignancy was disclosed but only inflammatory granulation tissue was seen in one of five specimens. A diagnosis of malignant lymphoma was made in the second biopsy specimens.

　At laparotomy the tumor was localized to the ileocecal region with no involvement of abdominal lymph nodes. On the resected specimen the tumor was situated at the ileo-cecal region involving the ascending colon and the terminal ileum. Its size of the ascending colon was 60×40 mm with two shallow ulcers and that of the terminal ileum was 70×40 mm with a shallow ulcer. Histologically, the tumor was diagnosed as reticulum cell sarcoma (pleomorphic type), but its site of origin was not clear.