| 特集名 | 悪性リンパ腫 | |
|---|---|---|
| 題名 | 大腸悪性リンパ腫の内視鏡診断 | |
| 発刊年月 | 1998年 03月 | |
| 著者 | 勝又 伴栄 | 北里大学東病院消化器内科 |
| 【 要旨 】 | 原発性大腸悪性リンパ腫(大腸ML)13例，17病変の内視鏡診断と生検組織学的検討を行った．大腸MLは回盲部と下部大腸に好発し，隆起型4例，潰瘍型4例，動脈瘤型3例，びまん浸潤型2例を認めた． 内視鏡所見の特徴としては，(1)隆起の表面は光沢を有し，基部はなだらかで粘膜下腫瘍の性格を示す，(2)潰瘍の辺縁は比較的鮮明で平滑，管腔の伸展性が良い，などであった．動脈瘤型MLは，内腔の区域性拡張，内面の粗大結節状肥厚に多発びらんを伴う特有の形態で診断学的である．大腸MLの内視鏡下生検に工夫を加えることにより，生検組織診断率を80%以上に向上させることが可能であった． |
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| Theme | Malignant Lymphoma of the GI Tract | |
|---|---|---|
| Title | Endoscopic Diagnosis of Malignant Lymphoma of the large Intestine | |
| Author | Tomoe Katsumata | Department of Internal Medicine, Kitasato University East Hospital |
| [ Summary ] | Seventeen lesions from 13 cases of primary malignant lymphoma in the ileocecal region and the large intestine were studied endoscopically. The cases could be classified macrospically as follows; 4 of polypoid type, 5 of ulcerative type, 3 of aneurysmal type and 2 of diffuse type. Fifty-four percent of these lesions were seen in ileococal region. Endoscopically, they had the following characteristics ; Polypoid type lymphomas had a glossy surface and gently-sloping tumors base. Ulcerative type lymphomas also had the characteristic feature of a submucasal tumor at the nlcer margin. Aneurysmal type lymphomas had the most characteristic diagnostic features, like primary lymphoma of the intestine. We observed segmental dilatation of the intestine. We obseved segmental dilatation of the intestinal canal and thickened mucosa associated with multiple erosions endoscopically. Histological diagnosis was comfirmed in 10 (83%) of 12 malignant lymphoma cases, employing direct-vision biopsy by colonoscopy. It was concluded that colonscopy and direct-vision biopsy are very useful for diagnosing mailgnant lymphoma of the large intestine. |
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