腸重積像を呈した横行結腸GISTの1例

Gastrointestinal Stromal Tumor (GIST) with Intussusception of the Transverse Colon, Report of an Adult Case

要旨　患者は，50歳，女性．腹痛を主訴に当院を受診した．腹部超音波検査および腹部CT検査にて横行結腸左側に腸重積に特徴的な所見を見い出した．注腸X線検査，下部消化管内視鏡検査にて同部に約3cm大の表面全体に潰瘍を伴う広基性の硬い隆起病変を認めた．切除標本の病理組織および免疫組織化学的検索では横行結腸gastrointestinal stromal tumor，neural typeと診断された．GISTは固有筋層に主座を置き，管腔内に突出する場合には腸重積を併発しやすいと考えられた．

　A50-year-old woman was admitted to our hospital with abdominal pain. Ultrasonography and computed tomography revealed that the intussusception was caused by a protruded tumor of the transverse colon. Laparoscopy-assisted left colectomy was performed. The resected tumor was 3.5×2.5×2.4cm in size. Histopathologically, on HE staining, spindle cells revealed fascicular proliferation. Considering these results as well as those of immunological stainings which were positive for S-100and c-kit, neural type GIST was diagnosed.

　1) The Department of Surgery, Fukui Prefectural Hospital, Fukui, Japan

　2) The Department of Pathology, Fukui Prefectural Hospital, Fukui, Japan

　3) The Department of Medicine, Fukui Prefectural Hospital, Fukui, Japan