腸間膜原発悪性リンパ腫の1例

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  • A CASE OF MALIGNANT LYMPHOMA OF THE MESENTERIUM

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A relatively rare case of malignant lymphoma of the mesenterium is reported with a review of the literature.<br> A 54-year-old man was admitted to the hospital because of an abdominal tumor. An increase in LDH was noted. An elastic hard and well movable tumor 20cm in diameter around the navel was palpated. On imagings, the tumor was associated with sandwich sign by an abdomina CT scan, was visualized as a hypovascular tumor on an angiography of the superior mesenteric artery. Upon laparotomy, a tumor 15cm in size in the mesentery of the small intestine and lymph node swelling along the superior mesenteric artery starting from the pancreatic inferior margin were seen. The main tumor alone was excised as possible as we could.<br> Histopathological diagnosis was malignant lymphoma (diffuse, large cell. B cell type) . It was inferred that transformation from follicular type to diffuse type might occur, because lymph node surface marker CD 10 was positive. It indicated a poor prognosis for the patient and postoperative chemotherapy was added.<br> It is said that malignant lymphoma of the mesentery presents difficulty in preoperative diagnosis and has a poor prognosis. Radical operation can be performed only in limited patients. We think that it is better to switch to chemotherapy as soon as possible rather than to pursur surgical therapy.

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