Department of Surgery, Nippon Steel Yawata Memorial Hospital, 1-1-1 Harunomachi, Yahatahigashi-ku, Kitakyushu, 805-8508, Japan.
Surg Today. 2011 Jul;41(7):1007-10. doi: 10.1007/s00595-010-4399-5. Epub 2011 Jul 12.
A 67-year-old woman with bloody stools underwent esophagogastroduodenoscopy and colonoscopy, which revealed the presence of a submucosal tumor in the stomach and an adenocarcinoma in the ascending colon. Preoperative screening disclosed an additional 10-cm tumor in the abdomen between the gastric and colonic lesions. Single-balloon enteroscopy was therefore performed. A nonstenotic, circumferential, bleeding ulcerative lesion was found in the jejunum, and the biopsy revealed malignant lymphoma (ML). A partial resection of the small intestine, ascending colectomy, and wedge resection of the stomach were performed, then systemic chemotherapy for ML was started 2 weeks after surgery. Triple gastrointestinal malignant tumors with different histologies are extremely rare, and have not been previously reported. Single-balloon enteroscopy in this case led to a definite diagnosis by biopsy, thus allowing the patient to receive chemotherapy as soon as possible after surgery.
一位 67 岁女性因便血接受了食管胃十二指肠镜和结肠镜检查，结果显示胃内有黏膜下肿瘤，升结肠有腺癌。术前筛查发现胃和结肠病变之间的腹部还有一个 10 厘米大的肿瘤。因此进行了单气囊小肠镜检查。在空肠发现一个非狭窄、环状、出血性溃疡性病变，活检显示恶性淋巴瘤（ML）。行小肠部分切除、升结肠切除术和胃楔形切除术，术后 2 周开始进行 ML 的全身化疗。三种不同组织学类型的胃肠道恶性肿瘤极为罕见，既往未有报道。本例中单气囊小肠镜检查通过活检明确诊断，使患者在术后尽快接受化疗。
