消化管粘膜下腫瘍の生検・細胞診

Biopsy and Cytology of Gastrointestinal Submucosal Tumors

要旨　消化管粘膜下腫瘍における鑑別診断は，とりわけ内視鏡的超音波検査（EUS）から得られる様々な所見により，ある程度の絞り込みが可能となってきた．しかし，質的診断や良・悪性の鑑別に難渋する例もあり，特に間葉系腫瘍に関してはそうであることが多い．このような症例に対し，現在最も高率かつ安全に生検診・細胞診を行える検査法がEUSガイド下穿刺吸引法（EUS-guided fine needle aspiration；EUS-FNA）である．これによって得られた検体に対しては，HE染色はもとより免疫学的染色も可能であり，診断能は確実に向上するものと考えられた．

　In the differential diagnosis of gastrointestinal submucosal tumors (SMTs), endoscopic ultrasonography (EUS) is the most reliable diagnostic tool, but, in cases of gastrointestinal mesenchymal tumors, it has been difficult to make a histological diagnosis based on indirect evidence regarding the nature of the lesion. However, for such cases, EUS-guided fine needle aspiration (EUS-FNA) has been developed as a safe and reliable method for making a better histological diagnosis. EUS-FNA biopsy specimens are sensitive to hematoxylin and eosin stain as well as to immunohistochemical staining, so it may be concluded that EUS-FNA improves our diagnostic ability to differentiate SMTs.

　1) Department of Radiology, National Kyushu Cancer Center, Fukuoka, Japan

　2) Department of Radiology, National Kyushu Medical Center, Fukuoka, Japan

　3) Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan