転移性腫瘍の形態的特徴―十二指腸

Morphological Features of Metastasis : Duodenum

要旨　十二指腸転移性腫瘍63例の画像所見を検討した．原発部位は，近接臓器である膵，結腸，胆道，胃を多く認めた．遠隔臓器は，子宮，卵巣，肺など，8例と少数であった．膵頭部癌からの転移は，十二指腸下行部内側からの圧排所見が特徴的であり，膵尾部癌からの転移では，狭窄や潰瘍を認めた．結腸癌の直接浸潤では下行部狭窄が主体であり，再発例では，リンパ行性転移による水平部や上行部の変化も認めた．胃からの転移では，転移経路が種々なため多彩な所見を認めた．胆道からの転移では，球部・下行部に外側からの圧排，狭窄を認めた．腹部外からの転移では，bull's eye病変を認めた．

　We evaluated 63 cases of duodenal metastases. Primary sites were mainly the pancreas, colon, biliary tract, and stomach. Distant primary sites including the uterus, ovary, and lung were not common. Metastases from pancreas head carcinoma showed compression to the medial wall of the 2nd portion of the duodenum. Metastases from pancreas tail carcinoma showed stenosis and ulceration. Direct invasion from colon carcinoma showed stenosis of the 2nd portion. Recurrent colon carcinoma showed 3rd and 4th duodenal lesions due to lymphadenopathy. Metastases from the stomach showed variable appearances. Metastases from the biliary tract showed compression and stenosis of the 1st and 2nd portion. Metastasis from the extraabdomen area showed a polypoid mass with central ulceration (bull's eye).