全周性潰瘍を呈した空腸原発follicular lymphomaの1例

Follicular Lymphoma with a Circumferential Ulceration in the Jejunum, Report of a Case

要旨●患者は60歳代，女性．変形性膝関節症に対して非ステロイド性抗炎症薬を内服していた．黒色便，貧血を認めたため，近医で上・下部消化管内視鏡検査を施行したが明らかな異常所見を認めなかった．小腸精査目的で当科へ紹介され受診となった．カプセル内視鏡検査（CE）にて，空腸に全周性の潰瘍性病変とその近傍に白色顆粒状隆起を認めた．ダブルバルーン内視鏡検査（DBE）でも同様の所見を認め，生検にてFL（follicular lymphoma）Grade 1と診断した．PET-CT検査にて病変は空腸に限局しており，腹腔鏡下空腸部分切除術を施行した．以上，CEで指摘しDBE下生検で確定診断した比較的まれな潰瘍型空腸原発FLの1例について画像所見の特徴を含め報告した．

　A 60-year-old woman was administered with nonsteroidal anti-inflammatory drugs for treating knee osteoarthritis. She underwent esophagogastroduodenoscopy and colonoscopy at another hospital in response to melena and anemia, but there were no obvious abnormal findings. Therefore, she was admitted to our hospital for further investigation of the small bowel. Capsule endoscopy showed a circumferential ulcerated lesion in the jejunum and multiple whitish nodules situated proximally to the ulceration. The results of double-balloon endoscopy were consistent with those of capsule endoscopy, and the biopsy from whitish nodules showed follicular lymphoma grade 1. PET-CT showed a positive lesion that was limited to the jejunum. Laparoscopic partial resection of the jejunum was subsequently performed. Pathological examination confirmed follicular lymphoma grade 1.