切除可能であった胃癌とCML合併の1例

抄録

A 46-year-old female was admitted to Kyoto First Red Cross Hospital with the complaint of hematemesis and melena. An ulcerated lesion at gastric antrum was found by the upper gastrointestinal series and endoscopy and biopsy-specimen showed group V. The peripheral blood findings revealed anemia, leukocytosis with immature granulocytes, and normal neutrophil alkaline phosphatase activity. The bone marrow was markedly hypercellular with positive Ph¹ chromosome, 46, XX, t (9; 22) (q³⁴; q¹¹). The vitamin B₁₂ level was high.
Since these findings revealed chronic myelogenous leukemia associated with gastric cancer, gastrectomy was performed. The resected specimen showed Borrmann type II gastric cancer, 2×2 cm in size. Histological examination showed tubulary and muconodular adenocarcinoma.
The incidence of patients with leukemia and coexistent primary cancer was found to be 0.56∼0.64% in Japan, which seemed to be lower than that in the United States. Five cases with the coincidence of chronic myelogenous leukemia and gastric cancer have been reported in Japan.