消化管炎症性類線維ポリープ（IFP）の診断と治療

Diagnosis and Treatment of Inflammatory Fibroid Polyp of the Gastrointestinal Tract

要旨　inflammatory fibroid polyp（IFP）は消化管の粘膜下層に発生する良性の疾患であり，いまだ原因は不明であるが粘膜の過剰な修復反応により生じた炎症性病変と推測されている．消化管では胃からの発生が最も多く，次いで小腸，大腸の順に多くみられ，食道からの発生は極めてまれである．IFPの臨床像は，その発生部位によりやや異なっているが，いずれの部位においても亜有茎または有茎性の硬い粘膜下腫瘍の形態を呈し頂部にびらんや潰瘍を伴いやすく，典型例では陰茎亀頭様の特有な外観を呈する．ただし，典型例を除けば他の粘膜下腫瘍との鑑別は必ずしも容易ではなく，治療前の組織学的診断も困難なことが多い．治療としては，良性疾患で再発も極めてまれなことから，手技的に可能であれば内視鏡的切除が第一選択である．

　Inflammatory fibroid polyp (IFP) is a benign submucosal lesion of the gastrointestinal tract. Its etiology, suggested to be the involvement of inflammatory mechanisms or reactive responses, remains unclear. IFP arises in the gastrointestinal tract, predominantly in the stomach, followed by the small intestine, the colon, and rarely the esophagus. Although clinical features of IFP differ according to location in the gastrointestinal tract, morphologically, it has a penis-like appearance in the typical case, and usually forms a pedunculated or subpedunculated submucosal tumor with erosion or ulceration overlying the mucosa on the apex in all locations. However, it is not so easy to differentiate it from other submucosal tumors except for the typical case, and it is also difficult to obtain a histological diagnosis before treatment. With regard to the treatment, endoscopic resection is the most suitable method for IFP, if technically possible.

　1) Institute of Gastroenterology, Matsuyama Red Cross Hospital, Matsuyama, Japan