胃と腸49巻5号

2014年05月発行

増刊号 消化管悪性リンパ腫2014 主題 消化管原発aggressive lymphoma―その他のリンパ腫：Burkittリンパ腫

Burkittリンパ腫の診断と治療

著者： 森山一郎¹ 鈴宮淳司¹ 高橋勉¹ 熊野御堂慧¹ 大西千恵¹ 川上耕史¹ 井上政弥¹ 三宅隆明¹ 田中順子¹ 荒木亜寿香² 丸山理留敬² 原田祐治³ 三上博信⁴ 宮岡洋一⁵ 藤代浩史⁵ 今岡友紀⁶

所属機関： ¹島根大学医学部附属病院腫瘍・血液内科 ²島根大学医学部器官病理学 ³島根大学医学部附属病院病理部 ⁴島根大学医学部消化器肝臓内科 ⁵島根県立中央病院内視鏡科 ⁶島根県立中央病院内消化器科

ページ範囲：P.759 - P.767

Burkittリンパ腫は，進行が非常に速いが，治癒可能なB細胞リンパ腫で，腹部を中心とした節外病変を多く認め，腹痛や嘔吐，消化管出血，腸重積を主訴として発症することがある．骨髄や中枢神経系の浸潤もしばしば認める．診断は特徴的な組織所見を基本に，高度なKi-67陽性所見などの免疫形質の検討やMYC遺伝子などの遺伝子検索を含めて総合的に行う．進行が速いため，診断後直ちにCODOX-M/IVAC療法やhyper CVAD療法などの治療強度の高い化学療法を実施する．このような治療が実施できた場合，予後は良好である．リツキシマブ併用による上乗せ効果が認められ，特に強力な抗がん薬治療の施行が困難な患者の治療成績の改善が見込まれる．しかし，ランダム化試験は未実施で，今後の検討が必要である．

参考文献

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