消化管の悪性リンパ腫

48症例の臨床病理学的検討

抄録

A detailed clinicopathologic and immunohistochemical study was performed on 48 cases of primary gastrointestinal lymphoma which were collected from 1976 to 1987 in our department. Of the 48 malignant lymphomas (ML), 32 developed in the stomach, 7 in the small intestine, 7 in the ileocecal region, and 2 in the rectum.
The age of the patients ranged from 14 to 84 with the average of 62. The ratio of male to female cases was 1:1 in gastrointestinal ML. The rate of the cases diagnosed clinically as ML was low; 3% were diagnosed by endoscopy and 29% by biopsy in gastric ML. Macroscopic types of gastric ML were divided according to Sano's classification and intestinal ML according to Wood's classification. In gastric ML, 50% of the cases were the ulcerative type, and the body of the stomach was commonest site. All cases in the present study were non-Hodgkin lymphomas and the most were diffuse type histologically, and only 4% were follicular lymphomas. Following the LSG classification, 57% in gastric MLs and 75% in intestinal MLs belonged to diffuse large ML. Immunohistochemical studies revealed 46 cases (96%) of the present study to be of B cell origin. As one case of gastric ML was positive for T cell markers, MT-1 and UCHL-1, this case was considered to be of T cell origin. Another case of gastric ML was positive for lysozyme, suggesting to be of histiocytic origin. The extent of tumor stage (pathological stage) and the tumor size but not histologic type were the major determinants of prognosis.