早期胃癌と合併した広範な胃サルコイドの1例

A Case Report of Widespread Gastric Sarcoid Coexisted with Early Gastric Cancer

　サルコイドーシスは系統的全身疾患で，リンパ節，肺，眼，皮膚，骨などに好発するが^8)12)20)30)特に胃に限局したサルコイドの報告はきわめて少く，諸外国の報告例を集計しても46例，本邦では17例に過ぎない．そのうち，胃癌と胃サルコイドの合併例は，外国ではBauerの1例，本邦では，門田，佐藤の2例のみであった．最近，われわれはこの稀な1例を経験したので，若干の文献的考察を加えて報告する．

　Sarcoidosis is systemic granulomatous disease of unknown etiology and pathogenesis. Gastric sarcoid is most uncommon.

　Up to 1973 only 46 cases of gastric sarcoid were reported in the foreign countries and 17 cases in Japan. Especially, gastric sarcoid coexisted with gastric cancer were only 3 cases in the world literature.

　A 60-year-old man was performed a Billroth I subtotal gastrectomy for an early gastric cancer. The microscopic diagnosis was early gastric cancer at the posterior wall of the mid-corpus (Adenocarcinoma mucocellulare, Ⅲ＋Ⅱc.) and gastric sarcoid localized in the mucosa. The granulomas were uniform in size, showed no necrosis, consisted chiefly of mononuclear cells and epitheloid cells, and contained a moderate number of giant cells.

　Regional lymph-nodes revealed no metastatic carcinoma but contained sarcoid lesions in all.

　The post-operative course was uneventful. He was discharged 2 weeks after operation, and is being followed-up in the Out-patient Department.