腸間膜動脈の外膜肥厚を伴った小腸カルチノイドの１例

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  • Elastic Vascular Sclerosis of Mesenteric Artery associated with Carcinoid Tumor: A Case Report

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A 52-year-old man, twice indicated as having liver nodules and admitted for abdominal pain, lower lum-bar pain, and diarrhea, was found to have rebound tenderness at the nodule in the right lower quadrant. Com-puted tomography showed multiple liver nodules, continuous wall thickening along the small intestine, and lymph node swelling in the mesentery, all hypervascular. Enteral fluoroscopy showed ileal sclerosis, wall roughness, and circular shadowless lesion. The elevated tumor in the terminal ileum was diagnosed preopera-tively by biopsy as a carcinoid tumor. Serum 5-HIAA and serotonin were high. Surgery was done due to ab-dominal pain and diarrhea upon oral intake, and 50 cm of the ischemic sclerotic intestine was resected. The specimen showed multiple yellow elastic hard tumors, diagnosed histologically as carcinoid tumors. The pecu-liar elastic vascular sclerosis in the mesenteric artery was also detected in the ischemic lesion of the ileum.

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