내시경 핵적출술로 제거한 점막하 종양 형태의 위 림프상피양 암종 1예
A Case of Endoscopic Enucleation for Gastric Lymphoepithelioma-like Carcinoma
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초록
림프상피양 암종(lymphoepithelioma-like carcinoma)은 위암의 약 1∼4%를 차지하는 매우 드문 암으로, 림프구 간질을 특징으로 하며 점막하 종양 형태는 매우 드물다고 알려져 있다. 점막하 종양은 내시경 초음파 및 이를 통한 조직 검사 방법으로 양성과 악성의 감별이 가능하나, 아직도 많은 경우, 특히 크기가 작은 경우에는 조직의 획득이 쉽지 않다. 최근 내시경을 이용한 일괄절제술 등을 통해 정확한 진단 및 치료를 하려는 연구가 시도 되었다. 이에 저자들은 작고 비특이적인 내시경 초음파 소견을 가진 점막하 종양을 진단 및 치료 목적으로 내시경 핵적출술을 시행하였으며, 조직검사에서 위 림프상피양 암종으로 진단된 예를 경험하였기에 보고한다.
Abstract
Lymphoepithelioma-like carcinoma (LELC) is a rare cancer and it makes up about 1∼4% of all gastric malignancies. The main histologic feature of LELC is a lymphoid stroma. LELC is rare in that its shape is similar to that of submucosal tumor (SMT). Although SMT can be divided into malignant and benign tumors, using endoscopic ultrasonography (EUS) and EUS-guided fine needle aspiration, there are still many cases that can't be discriminated, and it is especially difficult to obtain specimens due to the small size of SMT. There have been some recent trials to endoscopic remove small SMTs for the purpose of making an exact diagnosis and guiding therapy. We report here a case of gastric LELC that exhibited the features of a submucosal tumor, and this LELC was removed by endoscopic enucleation. We also briefly review the relevant medical literature.
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