食道脂肪腫の1例

Esophageal Lipoma, Report of a Case

要旨　患者は53歳，女性．上部消化管内視鏡検査で食道ポリープを指摘され，当院に紹介された．内視鏡検査では，胸部下部食道にともに大きさ約1cmの，2個の黄色調粘膜下腫瘍を認めた．超音波内視鏡検査では，内部均一な高エコー像を呈した．多発性食道脂肪腫と診断し，内視鏡的粘膜切除術（EMR）を施行した．腫瘍は，粘膜下層において成熟した脂肪組織の結節性分葉状の増生を認め，脂肪腫と診断された．食道脂肪腫は食道良性腫瘍の中でも非常にまれである．黄色調の柔らかい粘膜下腫瘍の形態を示し，診断には通常内視鏡検査に加え超音波内視鏡検査が有用である．粘膜下層に主座をもつ病変であり，内視鏡治療の良い適応である．

　The case is a 53-year-old female. Endoscopic examination revealed two neighboring yellowish submucosal tumors about 10 mm in diameter located in the lower part of the thoracic esophagus. EUS showed a homogeneous high echoic mass in the submucosal layer. The tumors were diagnosed as multiple lipoma of the esophagus and resected by EMR. Histological findings showed lipoma with lobulated growth of mature adipose tissue. Esophageal lipoma is very rare among esophageal submucosal tumors. Endoscopic findings showed a yellowish and soft submucosal tumor and EUS was useful for it's diagnosis. It was located mainly in the submucosal layer and EMR was effective for it's treatment.