特殊組織型の食道癌―内視鏡の立場から

Special Pathological Type Carcinoma in the Esophagus―from Endoscopic Findings

要旨　扁平上皮癌，腺癌以外の特殊組織型の食道癌は3％程度を占めるにすぎない．小細胞型未分化癌，類基底細胞癌，腺様嚢胞癌，腺扁平上皮癌などは隆起を主体とした発育を示し，また，粘膜上皮に被覆されている部分が多いという特徴があるが，腫瘍の立ち上がり，表面の凹凸，びらん・潰瘍の有無，などにより鑑別される．扁平上皮癌も含めて鑑別が困難なものもあるが，一般的な鑑別の要点を示した．また，特殊組織型扁平上皮癌の発育形式とその過程を推定した．

　Special histopathological types of carcinoma occupy only 3 ％ of esophageal cancer, while most others are classified as squamous cell carcinoma and adenocarcinoma. The special types include undifferenciated small cell carcinoma, basaloid carcinoma, adenoidcystic carcinoma and adenosquamous carcinoma, all of which show a protruding development generally covered totally or partly with normal mucosa. These can be distinguished from each other by the manner of protruding, by superficial irregularity and by the existence of erosion and ulcer. The principle ways of differentiation are described though we also encounter borderline cases including squamous cell carcinoma which are hard to distinguish. The development procedure of the special type of esophageal carcinoma is also mentioned.