臨牀消化器内科 Vol.19 No.5(5)


特集名 H.pylori陰性上部消化管疾患 -- 21世紀の疾病構造の推移を念頭に
題名 H.pylori陰性胃MALTリンパ腫
発刊年月 2004年 05月
著者 中村 昌太郎 九州大学大学院医学研究院病態機能内科学
著者 飯田 三雄 九州大学大学院医学研究院病態機能内科学
【 要旨 】 Helicobacter pylori (H.pylori) 陰性胃MALTリンパ腫の臨床病理学的特徴について，自験例の成績を含め，文献報告を中心に概説した．H.pylori陰性胃MALTリンパ腫は，H.pylori陽性例と比べ，深部浸潤例およびAPI2-MALT1キメラ分子陽性例が多く，Helicobacter heilmannii感染例などを除き，除菌治療の効果は期待し難い．H.pylori陰性例の組織学的特徴として，萎縮や腸上皮化生はなく炎症細胞浸潤に乏しいこと，腫瘍細胞は粘膜深部を中心に均一かつ単調な増殖を示すこと，lymphoepithelial lesionは少ないことなどが挙げられている．
Theme H.pylori Negative Upper Gastroenterological Diseases; Increasing of Their Incidence in the 21st Century
Title Helicobacter pylori-Negative Gastric MALT Lymphoma
Author Shotaro Nakamura Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu Universlty
Author Mitsuo Iida Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu Universlty
[ Summary ] The clinicopathologic features of Helicobacter pylori (H.pylori)-negative gastric MALT lymphoma were described. Compared to H.pylori-positive cases, H.pylori-negative gastric MALT lymphomas tend to show deeper invasion of the gastric wall, and have t(11;18)(q 21;q21) or API2-MALT chimeric transcript more frequently. Most cases with H.pylori-negative gastric MALT lymphoma do not respond to eradication therapy except for Helicobacter heilmannii-associated cases. Several histologic features of H.pylori-negative MALT lymphoma have been suggested, including uniform and monotonous proliferation of neoplastic cells mainly in the deep portion of the mucosa, lacking glandular atrophy, intestinal metaplasia, or lymphoepithelial lesions.
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