⑭表層拡大型（Ⅱc＋Ⅲ型早期胃癌類似）を示した胃濾胞性リンパ肉腫の1例

Follicular Lymphosarcoma Superficially Extended in Stomach (Like Ⅱc+Ⅲ Early Carcinoma)

　胃体部から前庭部へかけて広範囲に存在するⅡc＋Ⅲ型類似胃癌ないしは多発潰瘍に伴うreactive lymphoreticular hyperplasiaと鑑別が困難であった表在性の胃濾胞性リンパ肉腫を経験したので報告する．

　We report here a case of follicular lymphosarcoma which extended superficially in the corpus and antrum. Its gross appearance was similar to early gastric carcinoma type Ⅱc+Ⅲ.

　The patient, a 64 years old woman, was suffering from stomachache radiating to the back before eating. X-ray examination revealed an ulcer surrounded by shallow mucosal depression like Ⅱc type carcinoma on the corpus and destruction of the areas and irregular nodules on the antrum. Diagnosis of superficially extended early carcinoma type Ⅱc+Ⅲ was made (Fig. 1, 2, 3). Endoscopic study showed five ulcers surrounded with extended shallow mucosal depression on the corpus. Many small irregular erosions, nodular mucosal elevations, and clots were found within this mucosal depression and also on the antral mucosa. Gastric wall appeared to be soft. Diagnosis of reactive lymphoreticular hyperplasia with multiple ulcers was made by these endoscopic findings (Fig. 4, 5). Repeated biopsies showed no evidence of malignancy. Gastric juice was normoacidic.

　Gastrectomy with extended lymph node dissection was performed on January 31, 1977. Gross findings of the resected stomach corresponded with previous studies. Histologic study showed lymphosarcoma cells mainly in the mucosa and submucosa, and focal infiltration of sarcomatous cells into the muscular tissue. Seven of 23 dissected lymph nodes contained metastatic cells.

　Postoperative progress is satisfactory.