腹部超音波ガイド穿刺吸引細胞診を施行し得た小腸腫瘍の1例

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  • A CASE OF SMALL INTESTINAL TUMOR DIAGNOSED BY ULTRASONOGRAPHY-GUIDED NEEDLE ASPIRATION CYTOLOGY

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We report a case of small intestinal tumor diadnosed by ultrasonography-guided needle aspiration cytology. A 58-year-old woman was admitted to the hospital because of melena and severe anemia, Hb was 6.9g/dl and RBC was 249×104/μl. Although both upper and lower digestive tracts were routinely examined, no abnormal findings were seen. Radiography of the small intestine revealed a type 2 tumor with deep ulceration in the jejunum at the site of 10cm to the Treitz's ligament. Endoscopic examination of the small intestine identified submucosal tumor with ulceration at the same part. Ultrasonic examination revealed a mass with the size of 2cm. An ultrasonography-guided needle aspiration cytology was performed. Obtained specimen showed spindle cells that were similar to myogenic cells. A partial jejunectomy was performed. Histology showed that the ressected tissue contained dysplastic cells with few mitotic cells in a high power view field. In conclusion, it was diagnosed as stromal tumor, smooth muscle type, borderline malignancy of the jejunum. This ultrasonography-guided needle aspiration cytology contributed to make qualitative diagnosis in this case.

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