Tamai Yasuyuki, Murakami Eiko, Nakamori Yoshiki, Mizutani Minoru, Sekine Takao
Dept. of Hematology, Matsusaka Chuo General Hospital.
Gan To Kagaku Ryoho. 2011 Aug;38(8):1371-3.
A 59-year-old man presented to his general practitioner(GP)complaining of gastric discomfort. Endoscopy revealed an irregular ulcerative region from the gastric lower body to the pylorus. The GP sent the patient to our hospital. With a diagnosis of diffuse large B-cell lymphoma(DLBCL)based on biopsy findings, the patient was treated with R-CHOP chemotherapy. After two courses of this regimen, the patient had vomiting on several occasions. A computed tomography(CT)examination and endoscopy showed that the tumor decreased, but a tight stenosis was located at the pylorus. Because he had trouble continuing chemotherapy, a gastrojejunal bypass operation was performed. The patient did not have vomiting and was able to take meals. After this chemotherapy, CT examination and biopsy findings confirmed that the DLBCL and lymph node metastases had disappeared. Gastrojejunal bypass is expected to be an effective method for treating gastric stenosis during the chemotherapy of DLBCL.
一名59岁男性因胃部不适前往全科医生(GP)处就诊。内镜检查发现胃体下部至幽门有不规则溃疡区域。全科医生将患者转诊至我院。根据活检结果诊断为弥漫性大B细胞淋巴瘤(DLBCL),患者接受了R-CHOP化疗。在该方案进行两个疗程后,患者多次出现呕吐。计算机断层扫描(CT)检查和内镜检查显示肿瘤缩小,但幽门处出现严重狭窄。由于他难以继续化疗,遂进行了胃空肠吻合术。患者不再呕吐,能够进食。此次化疗后,CT检查和活检结果证实DLBCL及淋巴结转移均已消失。胃空肠吻合术有望成为DLBCL化疗期间治疗胃狭窄的有效方法。