⑯消化性潰瘍を併存した多発平皿状腫瘤を呈する胃悪性リンパ腫の1例

Malignant Lymphoma of the Stomach Showing Multiple Saucer-like Appearance with Peptic Ulcers

　消化性潰瘍を伴い多発の平皿状腫瘤の形態を呈した早期胃細網肉腫の1例を経験したので，X線，内視鏡所見を中心に報告する．

　症　例

　患　者：渡○ト○，55歳，女．

　主　訴：空腹時心窩部痛，体重減少．

　家族歴：兄姉結核．

　既往歴：特になし．

　現病歴：1970年11月頃より空腹時心窩部鈍痛が出現する．1971年7月に某医を受診し，胃X線検査にて異常を指摘され，豊橋市民病院を受診する．

　The following is a summary of the x-ray and endoscopic findings of the stomach of a 55 year-old woman with hunger pain in the epigastrium and weight loss.

　1. Multiple masses of peculiar shape were found on the posterior wall of the gastric body, converging to a central ulcer in a four-leaf clover fashion. They were round and saucer-like. Almost all of the surface of the masses were occupied by shallow, concentric depressions with smooth rims.

　2. In a short time, the forms of the lesions underwent a remarkable change.

　3. Ulcer lesions were observed both in the center of the multiple masses on the posterior wall and just at the opposite side of the anterior wall.

　These results led to a clinical diagnosis of malignant lymphoma of the stomach. The final diagnosis after surgical and pathological explorations was reticulum cell sarcoma with scars of multiple ulcer. Histologically, proliferation and infiltration of the tumor cells were limited to the mucosa and submucosa, but these cells were also found in the regional lymph nodes.