Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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A Case of Duodenal Mucosa-associated Lymphoid Tissue Lymphoma Presenting as a Refractory Ulcer

난치성 궤양 형태로 발현한 십이지장의 MALT 림프종 1예

  • Song, Min-Keun (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Kang, Hyoun-Woo (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Kim, Jae-Hak (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Lee, Jun-Kyu (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Lim, Yun-Jeong (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Koh, Moon-Soo (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Lee, Jin-Ho (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Kim, Eo-Jin (Department of Internal Pathology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine)
  • 송민근 (동국대학교 의과대학 일산병원 내과학교실) ;
  • 강현우 (동국대학교 의과대학 일산병원 내과학교실) ;
  • 김재학 (동국대학교 의과대학 일산병원 내과학교실) ;
  • 이준규 (동국대학교 의과대학 일산병원 내과학교실) ;
  • 임윤정 (동국대학교 의과대학 일산병원 내과학교실) ;
  • 고문수 (동국대학교 의과대학 일산병원 내과학교실) ;
  • 이진호 (동국대학교 의과대학 일산병원 내과학교실) ;
  • 김어진 (동국대학교 의과대학 일산병원 병리학교실)
  • Published : 2011.07.30
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Abstract

Mucosa-associated-lymphoid-tissue (MALT) lymphomas are the most common primary gastrointestinal lymphomas. The stomach is the most common site of involvement in the GI tract. However, MALT lymphoma of the duodenum is rare. The differential diagnosis in a refractory peptic ulcer are current smoking, NSAID use, hypersecretory conditions (gastrinoma and Zollinger-Ellison syndrome), neoplasms, infection (cytomegalovirus, syphilis, and tuberculosis), and Crohn's disease. Endoscopic findings of duodenal MALT lymphoma are classified as ulcerative, polypoid, and diffuse types. The ulcerative type is the most common type of duodenal MALT lymphoma. Here, we report a case of a 64-year-old male with a history of a refractory duodenal ulcer who was diagnosed with a duodenal MALT lymphoma by immunohistochemical staining.

MALT (mucosa-associated lymphoid tissue) 림프종은 위장관 림프종에서 가장 호발 하는 림프종으로 십이지장에서는 그빈도가 매우 낮다. 십이지장 MALT 림프종의 내시경적 소견으로는 궤양형, 융기형, 미만형으로 분류 되는데 그 중 궤양형이 가장 흔한 소견이다. 난치성 궤양의 경우 흡연, 비스테로이드성진통제 사용, 산의 과다 분비 상태(gastrinoma, Zollinger-Ellison syndrome 등), 종양, 크론병, 감염(결핵, 매독, cytomegalovirus) 등을 고려해야 한다. 64세 남자 환자에서 난치성궤양 형태로 발현된 십이지장 MALT 림프종 1예를 경험하였기에 문헌 고찰과 함께 이를 보고한다.

Keywords

References

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