食道粘膜下導管腺腫（submucosal gland duct adenoma）の1例

Submucosal Gland Duct Adenoma of the Esophagus, Report of a Case

要旨　症例は68歳，男性．上部消化管内視鏡検査にて食道病変を指摘されたため，当センターに紹介された．諸検査および生検で腺腫と診断し，ESDを施行，最終病理診断は食道固有腺由来の粘膜下導管腺腫であった．極めてまれな疾患であり，報告例は自験例を含めて世界でも13例のみである．今回われわれが，術前診断しえたのは，詳細に形態を観察したためと思われる．空気変形所見のない0-Isep型を呈するが，中心陥凹に不整さがないことや，自験例で観察されたIPCLは，粘膜下導管腺腫の特徴とも考えられる．病変の形態学的特徴を詳細にとらえることの重要性を再認識した症例であった．

　A 68-year-old male in whom gastrointestinal endoscopy had revealed a lesion in the esophagus, was referred to our center. We diagnosed it as adenoma from examinations and biopsy specimen and performed ESD. The final histological finding was submucosal gland duct adenoma originating from the esophageal proper gland. It is very rare and only 13 cases including the present case have been reported. We were able to make our diagnosis preoperatively because we investigated it in detail. We consider that 0-Isep without irregular depression and the IPCL (intra-epithelial papillary capillary loop) we observed are characteristic of submucosal gland duct adenoma of the esophagus.