胃と腸43巻7号

2008年06月発行

今月の主題 消化管follicular lymphoma―診断と治療戦略 主題

消化管濾胞性リンパ腫―特に十二指腸症例の臨床病理学的特徴

著者： 吉野正¹ 佐藤康晴¹ 市村浩一¹ 田中健大¹ 高田尚良¹ 守都敏晃¹ 大西尚子¹ 田村麻衣子¹ 岡田裕之² 河原祥朗² 竹中龍太² 田利晶³

所属機関： ¹岡山大学大学院医歯薬学総合研究科病理学 ²岡山大学大学院医歯薬学総合研究科消化器・肝臓・感染症内科学 ³広島赤十字原爆病院内科

ページ範囲：P.1039 - P.1046

要旨　濾胞性リンパ腫のほとんどはリンパ節原発であるが，節外性の中では消化管とりわけ十二指腸に原発する症例が目立つ．自験例では平均年齢58歳で性差はなく，十二指腸下行脚に主座を持つことが多い．major break pointにおける免疫グロブリン重鎖/bcl-2遺伝子再構成は検出されるが，節性のものに比して臨床病期が低く，大半がWHO分類のGrade 1，2でリンパ腫細胞は中型のものが主体で大型細胞の出現性も節性のそれに比べて低い．病変の進展は総じて緩徐である．VHのusageを検討するとVH4に偏ったusageになっている．このような性格はMALTリンパ腫のそれに近いものである．

参考文献

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