未知の原発部位の状細胞がんによる胃部地域リンパ節転移:症例報告
Toshiaki Komo1, Yoichi Sugiyama1, Takaaki Suwa1
1Department of Surgery, JA Hiroshima General Hospital, Hatsukaichi, Hiroshima, Japan.
Surgical case reports
|February 13, 2026
まとめ
未知の原発部位のがんから胃リンパ節への転移はまれである. 主要な腫瘍を特定することなくでも,感染した結節の外科的除去は,完全な切除とみなすことができます.
科学分野:
- 胃腸内科 胃腸内科
- 外科腫瘍学外科腫瘍学
- 病理学 パトロジー
背景:
- 未知の原発部位 (CUP) がんは,徹底的な調査の後も起源が特定されていない転移性腫瘍です.
- 胃部地域のリンパ節への転移は,CUPでは珍しい現象です.
研究 の 目的:
- 未知の原発部位の癌から胃リンパ節に転移した平細胞がんの希少な症例を報告する.
- このような希少なプレゼンテーションの診断と治療の影響を議論する.
主な方法:
- 胃下粘膜腫瘍を呈した75歳の女性.
- 曖昧な細胞学のために診断は困難でした; リンパ節解剖によるオープン近接胃切除が行われました.
- 組織病理学では,胃のリンパ節に状細胞がんの転移を明らかにし,主要な部位は未特定のままである.
主要な成果:
- 腫瘍は状細胞癌のリンパ節転移として特定され,主に胃壁の外側に位置するが,それと臓を巻き込む.
- 徹底した調査にも関わらず,頭と首,食道,肺の原発腫瘍は特定できなかった.
- 患者は手術後にニボルマブを投与され,7ヶ月間再発なしでした.
結論:
- 未知の原発部位のがんから胃リンパ節への転移は,希少な臨床実体を表しています.
- 関連するリンパ節の完全な外科的切除は,主病変を特定せずにしても,これらのケースではR0切除に相当すると考えられます.
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