貧血が診断の契機となった巨大な胃炎症性類線維ポリープの1例

Huge Inflammatory Fibroid Polyp of the Stomach which was Discovered after the Onset of Anemia, Report of a Case

要旨　患者は，71歳，男性．健診で貧血を指摘され，精査のため当院を受診．上部消化管内視鏡検査で，胃体上部大彎に約7cmの巨大な腫瘤性病変が認められた．腫瘤の表面は比較的平滑であるが，一部にびらん性の変化が認められた．また上部消化管造影でも同様に巨大な腫瘤性病変が認められた．内視鏡時の生検では診断に至らなかったが，胃の腫瘤性病変が貧血の原因と考えられ，手術が施行された．摘出標本から病理学的に胃炎症性類線維ポリープ（IFP）と診断された．IFPは無症状で発見されることも多いが，本症例の場合，巨大であり，潜在的な出血から貧血を来したと考えられた．

　A 71-year-old man, presented anemia in medical examination and had a check-up in our hospital for more detailed inspection. On endoscopy, a big tumor, 7cm in size, was recognized at the greater curvature of the upper part of the stomach. The surface of the tumor was comparatively flat, but erosive change was recognized in one part. In addition, the same huge tumor in the upper digestive tract was recognized through barium study. We did not reach a diagnosis by endoscopic biopsy, but this huge tumor of the stomach was suspected to have caused the anemia, and an operation was performed. From a specimen extracted from it, the tumor was diagnosed as an inflammatory fibroid polyp. Many IFPs which are discovered are asymtomatic, but, in this case, the tumor was especially large and it was thought that anemia had been brought on by hidden hemorrhage.