粘膜下腫瘍様形態を示した食道癌―病理学的特徴

Pathological Characteristics of Esophageal Cancer Resembling Submucosal Tumor

要旨　粘膜下腫瘍様形態を示した食道癌19例(表在癌7例，進行癌12例)について検討した．臨床病理学的特徴としては，女性が相対的に多く，リンパ節転移が高率に陽性で，特殊な組織型の割合が多かった．特殊組織型以外にも，線維化を有する高分化扁平上皮癌やリンパ球浸潤の目立つ低分化扁平上皮癌が含まれていた．これらを形態形成の点から分類すると，①発生部位，②周囲間質反応，③組織学的特性に大別することができた．生検診断では，その形態にもかかわらず高率に癌の診断が可能であり，実際に粘膜下腫瘍との鑑別を要する病変は少数であった．

　Nineteen cases of esophageal cancer resembling submucosal tumors (7 cases of submucosal cancer and 12 cases of advanced cancer) were evaluated. Clinicopathological studies revealed they were rather more frequent in females and had a high frequency of lymph node metastasis with histological features different from squamous cell carcinoma. There were also well differentiated squamous cell carcinomas surrounded with fibrosis and poorly differentiated squamous cell carcinomas surrounded with lymphocyte infiltration. Classifying them according to shape or form, three influential factors were noted. First was their original location, second was their interstitial reaction, and third was the character of their histological features. In spite of these unique features, they were able to be correctly diagnosed and there was little difficulty in distinguishing them from submucosal tumors.