Sugimoto Atsushi, Tada Masaharu, Taji Tomoe, Houjo Yudai, Kanokogi Yu, Hirata Masaaki, Fujita Yusuke, Kawasaki Yusuke, Sakamoto Takashi, Yoshikawa Junichi, Iwama Hideaki, Usuki Shinichiro, Shirakata Yoshiharu, Tamura Jun, Maki Atsuhiko
Dept. of Surgery, Hyogo Prefectural Amagasaki General Medical Center.
Gan To Kagaku Ryoho. 2017 Apr;44(4):341-343.
A 57-year-old woman was admitted owing to epigastric pain.Abdominal computed tomography demonstrated a tumor in the origin of the jejunum.After an endoscopic biopsy, we diagnosed diffuse large B-cell lymphoma.We treated her with CHOP chemotherapy because pancreaticoduodenectomy is highly invasive.After 1 course of chemotherapy, the tumor was reduced.However, she developed a jejunal stenosis; therefore, we performed laparoscopic gastrojejunostomy.Furthermore, she developed perforated peritonitis on the sixth day after the surgery, and therefore, an emergency partial jejunum resection was performed.Histopathologically, viable lymphoma cells were not found in the resected intestine.She had a complete response 10 months after the surgery.Chemotherapy may cause intestinal stenosis and perforation requiring surgery; therefore, decisions about surgical procedures must be made carefully.
一名57岁女性因上腹部疼痛入院。腹部计算机断层扫描显示空肠起始部有一个肿瘤。经内镜活检后，我们诊断为弥漫性大B细胞淋巴瘤。由于胰十二指肠切除术具有高度侵袭性，我们对她进行了CHOP化疗。经过1个疗程的化疗，肿瘤缩小。然而，她出现了空肠狭窄；因此，我们进行了腹腔镜胃空肠吻合术。此外，她在手术后第六天发生了穿孔性腹膜炎，因此进行了急诊部分空肠切除术。组织病理学检查显示，切除的肠段中未发现存活的淋巴瘤细胞。术后10个月她获得了完全缓解。化疗可能导致需要手术治疗的肠道狭窄和穿孔；因此，必须谨慎做出关于手术方式的决定。
