大野 憲仁¹, 西村 庸夫², 大森 克介³, 大朏 祐治⁴

Norihito OHNO¹, Nobuo NISHIMURA², Katsusuke OHMORI³, Yuji OHTSUKI⁴

¹大野内科循環器科消化器科, ²松山市民病院内科, ³松山市民病院外科, ⁴高知医科大学第2病理

¹Ohno Clinic, ²Department of Internal Medicine, Matsuyama Shimin Hospital, ³Department of Surgery ,Matsuyama Shimin Hospital, ⁴Second Department of Pathology, Kochi Medical School

キーワード : Hepatocellular Carcinoma, Malignant lymphoma, Ultrasonograph

A 72-year-old man with a hyperechoic liver lesion that had previously been diagnosed as liver hemangioma sought medical consultation because of epigastralgia. Gastrointestinal fiberscopy (GIF) showed a gastric ulcer and multiple polypoid lesions in the duodenal bulb; and ultrasonography (US) showed a 46×33 mm hyperechoic lesion. The lesion had grown when a subsequent US examination was made, and the patient was transferred to Matsuyama Shimin Hospital for further examination. Examination of tissue from multiple polypoid lesions of the duodenal cap and terminal ileum indicated large-cell type diffuse malignant lymphoma with metastasis to the bone marrow. Segmental resection of the liver was performed, and the lesion was identified as hepatocellular carcinoma.