胃と腸48巻10号

2013年09月発行

今月の主題 小腸の悪性腫瘍 主題

小腸原発悪性リンパ腫の治療

著者： 小椋美知則¹

所属機関： ¹名古屋第二赤十字病院血液・腫瘍内科

ページ範囲：P.1474 - P.1480

要旨　小腸原発悪性腫瘍の15～20％がリンパ腫であり，非ホジキンリンパ腫（NHL）の30％を占める胃腸原発リンパ腫の中で，9～30％が小腸原発NHLである．小腸原発NHLで最も頻度の高いびまん性大細胞型B細胞リンパ腫（DLBCL）の治療方針は，初発限局期には病変部位の外科的切除後にR-CHOP療法6コース，初発進行期にはR-CHOP療法6～8コース，救援化学療法に奏効した65歳以下再発例には自家造血幹細胞移植併用の大量化学療法が標準的治療法である．十二指腸原発濾胞性リンパ腫は限局期症例が多く，緩徐な経過を示すため，リツキシマブ単剤治療や注意深い経過観察（watch & wait）も考慮すべき治療オプションである．小腸原発T細胞リンパ腫の予後はDLBCLと比べて不良であり，分子標的薬など新たな治療戦略の開発が望まれる．

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