回腸悪性リンパ腫による成人腸重積症の1例

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A case of 76-year-old man with ileal intussusception due to malignant lymphoma is reported with a review of 65 cases in Japanese literature. The patient complained of multiple mucous and bloody diarrhea and consulted our department. Barium enema and colonofiberscopy revealed a "sousage-like" structure in the terminal ileum. A preoperative diagnosis of an ileal intussusception was made, and partial resection of ileum including invaginated portion was performed. In the resected specimen, YAMADA III type polypoid lesion, 1.0×2.7cm in size, was detected at the top of inner part of intussusception. Pathological examination confirmed that the tumor was identical to a diffuse and large cell type of malignant lymphoma. 2 kur of chemotherapy (COPP) was done during postoperative convalescent period, and the patient discharged on 22 nd postoperative day. He did well and free of recurrence 36 months postoperatively. We must take the fact that an adult intussusception mostly results from intestinal malignant tumor in mind, when we encounter an adult patient who manufests symptoms suggesting an intussusception.
日本大腸肛門病学会の論文