EOSINOPHILIC GRANULOMA OF THE STOMACH PRESENTING MASSIVE HEMATEMESIS

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  • 大量吐血を主訴とした胃好酸球性肉芽腫の1例

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An unusual case of eosinophilic granuloma of the stomach was reported. A 49-year-female was admitted to our hospital with a complaint of massive hematemesis. Radio-logical and endoscopical studies showed an elevated lesion like a submucosal tumor with multiple ulcerations in the fornix. Biopsy specimen taken from the ulcerations were composed of normal mucosa, necrotic tissues and cellular infiltration with degeneration. Angiography showed a stretching of the left gastric artery and tumor vessels on arterial phase, and tortuous draining veins on the surface of tumor on venous phase. Five days later, the patient vomited blood again and the partial gastrectomy was subsequently done. Histologically, the lesion was composed of degenerated muscle layer and proliferative connective tissues including fibroblasts and marked hypervascularity. Diffuse infiltration with numerous eosinophilic leucocytes and lymphocytes was prominent. The final dia-gnosis was an eosinophilic granuloma. The granuloma most commonly affects the pyloric region of the stomach. It is rare that the granuloma presents in the fornix of the stomach and the chief complaint is hematemesis.

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