INTESTINE Vol.19 No.3(3-2)


「個人年間予約購読者用全文閲覧サービス」でこの号を見る
特集名 腸管悪性リンパ腫
題名 症例 (2) 十二指腸下行脚に狭窄をきたしたⅡ型腸管症関連T細胞性リンパ腫（enteropathy-associated T-cell lymphoma）の一例
発刊年月 2015年 05月
著者 石橋 英樹 福岡大学医学部消化器内科学
著者 竹下 盛重 福岡大学医学部病理学
著者 山田 梢 福岡大学医学部病理学
著者 二村 聡 福岡大学医学部病理学
著者 高松 泰 福岡大学医学部血液・腫瘍・感染症内科学
【 要旨 】 症例は70歳代，男性．嘔気を主訴に当科紹介．上部消化管内視鏡検査にて十二指腸下行脚に全周を占める粘膜下腫瘤様の隆起，管腔の狭窄化を認めた．腫瘤から生検し，Ⅱ型腸管症関連T細胞性リンパ腫（Ⅱ型enteropathy-associated T-cell lymphoma；EATL）と病理診断した．PET-CTでは十二指腸下行脚以外に異常所見は認めず，骨髄生検像では骨髄浸潤が強く疑われた．十二指腸に発生したⅡ型EATL，臨床病期Ⅳ期（Lugano国際会議分類）と診断し，化学療法を2コース施行したところ，腫瘍は縮小した．
Theme Intestinal malignant lymphoma
Title A case of enteropathy-associated T-cell lymphoma with stenosis in the second portion of duodenum
Author Hideki Ishibashi Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine
Author Morishige Takeshita Department of Pathology, Fukuoka University Faculty of Medicine
Author Kozue Yamada Department of Pathology, Fukuoka University Faculty of Medicine
Author Satoshi Nimura Department of Pathology, Fukuoka University Faculty of Medicine
Author Yasushi Takamatsu Department of Medical Oncology, Hematology and Infectious Diseases, Fukuoka University Faculty of Medicine
[ Summary ] A 70-year-old man visited our hospital complaining of nausea. Upper gastrointestinal endoscopy revealed a submucosal tumor and stenosis in the second portion of the duodenum. The pathological diagnosis based on the biopsy specimen was type II EATL. The disease was limited to the second portion of the duodenum, as revealed by 18F-FDG positron emission tomography. Bone marrow infiltration was suspected based on the biopsy findings. The final diagnosis was type II EATL in the second portion of the duodenum, with clinical stage IV disease (Lugano International Conference classification). Computed tomography (CT) scan of the abdomen showed reduction of the tumor volume after chemotherapy (SMILE therapy).
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