反復性出血を伴った胃・十二指腸の悪性リンパ腫に対し,内視鏡的止血法が有用であった1例

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  • A case of malignant lymphoma accompanied with repeated bleeding from the gastric and duodenal lesions treated by endoscopic hemostasis.

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We reported a case of malignant lymphoma accompanied with repeated bleeding from the gastric and duodenal lesions, which was treated by endoscopic hemostasis successfully. A 75-year-old male visited our hospital with blackish stool. The first upper GI endoscopy revealed that ulcerative lesions were in the stomach and the duodenum. On the 4th day of the hospitalization, follow-up endoscopy showed arterial bleeding from the ulcerative lesion in the fornix, and we treated it by endoscopic injection with pure ethanol and by clipping hemostasis. On the 11th day, bleeding from the ulcerative lesion in the second portion of the duodenum was treated by endoscopic injection with pure ethanol. His-tologically, the ulcerative lesions were consisted of the tissue of malignant lymphoma. Multiple lesions were seen in organs other than gastrointestinal tract, therefore an surgical operation was not performed and chemotherapy was selected. But on the 34th day and the 49th day of the hospitalization, we found bleeding from the duodenum and the fornix, and treated it by endoscopic hemostasis again. After that, the ulcerative lesions were getting smaller by the chemotherapy, and bleeding was not detected. We suggest that endoscopic hemostesis is effective against bleeding from ulcerative lesions consisted of the tissue of not only benign diseases but also malignant lymphoma.

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