食道ヨード不染帯の鑑別診断―癌と非癌の鑑別：病理の立場から

Diagnosis of Iodine Unstained Area in the Esophagus―Pathological Point of View

要旨　内視鏡的なヨード不染帯と生検病理所見との関係を検討するために39個の病巣を検討した．ヨード不染とparakeratosis，keratohyalin顆粒およびkoilocytosisとは密接な関係があることを示した．組織学的な（異型）基底細胞増殖巣は，内視鏡的に癌と診断された2/17病巣，癌疑いと診断された1/8病巣，非癌とされた4/14病巣に各々みられた．これらの病巣は，1例を除きkoilocytosisを認めた．典型的な異形成と言える病変はなかったが，癌と炎症を除いた（異型）基底細胞増殖巣が異形成の候補である可能性があり，koilocytosisとの関係が示唆された．

　Thirty-nine foci were examined in order to discover the relationship between endoscopic iodine non-stained area and the biopsy pathology. An iodine non-stained area in endoscopy and parakeratosis, keratohyalin granules and koilocytosis in the pathological view showed that there was a close relationship. Histological basal cell hyperplasia was seen under 2/17 focus endoscopically and diagnosed as cancer, 1/8 focus diagnosed it as suspect cancer, and 4/14 focus indicated that it was non-cancerous. These foci accepted koilocytosis except for one example. Excepting cancer and inflammation, a basal cell hyperplasia was strictly defined by focus. The basal cell hyperplasia with or without atypia had a possibility of being dysplasia, and a relationship with koilocytosis was suggested.