IIc型早期胃癌に類似した多発胃reactive lymphoreticular hyperplasiaの1例

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A 55-year-old female came into our hospital complaining of epigastric discomfort. About 3 months prior to admission, some abnormal findings were detected on the X-ray films of mass survey for gastric cancer. Multiple shallow ulcerations resembling IIc type early gastric cancer were revealed by reexamination of upper gastrointestinal series as well as endoscopic examination. The biopsy specimens suggested malignant lymphoma, showing marked lymphoid cell infiltration in the mucosa. Total gastrectomy was performed on Nov.6, 1976. The resected stomach showed 4 lesions: two Ul-II open ulcers, one Ul-II scar and one Ul-I (open erosion). In each lesion, marked proliferation of lymphoid tissue was seen, mainly in the lamina propria with a slight infiltration into the submucosa. Germinal center formation was not so remarkable. Cellular atypism was not observed. According to Nakamura's classification, the lesions were belonged to "diffuse and flat" form RLH macroscopically. The lesions were located in the fundic gland area and on the proximal site of intestinal metaplasia with marked atrophic gastritis. These findings differed from Nakamura's explanation. It is revealed that the lesions occured surrunding the gastric ulcers on the base of lymphoid proliferation associated with atrophic gastritis. The lesions were thought to be established when an uncertain deffensive reaction modified to those ulcers. A case of RLH associated with multiple gastric ulcers was presented, and it's pathogenesis was briefly discussed.
北里大学の論文
1976-10-31

IIc型早期胃癌に類似した多発胃reactive lymphoreticular hyperplasiaの1例

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