胃と腸39巻3号

2004年03月発行

今月の主題 胃MALTリンパ腫―除菌治療後の経過と予後 主題症例

胃MALTリンパ腫に対するH. pylori除菌治療後にdiffuse large B-cell lymphomaが出現した1例

著者： 福本晃¹ 北台靖彦¹ 益田浩¹ 趙成大¹ 吉田成人¹ 上野義隆¹ 茶山一彰¹ 伊藤公訓² 田中信治² 日山亨³ 吉原正治³ 中山宏文⁴

所属機関： ¹広島大学大学院医歯薬学総合研究科分子病態制御内科学 ²広島大学医学部・歯学部附属病院工学医診療部 ³広島大学保健管理センター ⁴広島大学大学院医歯薬学総合研究科分子病理学

ページ範囲：P.316 - P.322

要旨　73歳，男性．近医での上部消化管内視鏡検査にて，胃印環細胞癌を疑われ，当院を紹介受診した．当院での再検では胃体部から前庭部にかけて浅いびらんと粘膜の凹凸不整を認め，生検にて低悪性度胃MALTリンパ腫と診断された．Helicobacter pylori（H. pylori）感染は陽性で，API2-MALT1遺伝子異常を認めなかったため，除菌療法を施行した．除菌療法終了6週後に上部消化管内視鏡検査を施行したところ，H. pyloriは陰性化し，病変部の大部分の粘膜は平滑，褪色調となっていたが，胃角小彎後壁に不整形の潰瘍性病変の出現を認め，同部からの生検にてdiffuse large B-cell lymphomaと診断された．放射線化学療法施行後，完全寛解となり，経過観察中である．

参考文献

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