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要旨 症例は60歳代の女性.2005年7月,心窩部痛のため上部消化管内視鏡検査を施行し,胃体部に隆起性病変を指摘された.経過観察中の2007年3月,上部消化管内視鏡検査にて前回と同部位に有茎性隆起病変を認め,生検でGIST(gastrointestinal stromal tumor)と診断.外科的に胃局所切除を施行した.免疫染色にてc-kit陽性,s100蛋白陰性,desmin陰性であり,GISTと診断した.腫瘍は粘膜筋板に囲まれるように存在し,粘膜筋板由来のGISTと診断した.約1年9か月間,経時的に腫瘍の形態変化を観察しえた.
On gastrointestinal endoscopy, a 69-year-old female was found to have a pedunculated tumor in the greater curvature of the gastric upper body. Biopsy findings led us to diagnose a gastrointestinal stromal tumor(GIST), and partial resection of the stomach was carried out. The resected tumor was 45×25mm in size, and, on immunohistochemistry, was positive for c-kit but negative for S100 protein and desmin. These findings confirmed the diagnosis of GIST. Of special interest is the fact that the tumor was connected to the muscularis mocosae. In Japan there have been only two previous reports of GIST located in the stomach arising from the muscularis mucosae. Herein we show morphological changes of GIST observed over a period of 19 month.
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