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要旨 NSAID起因性小腸病変24例の生検材料を用いて臨床病理学的検討を行った.組織学的には全例で軽度~中等度以下の非特異性炎症を示し,その細胞浸潤形態は巣状であった.またうっ血・浮腫16例(66.7%),リンパ管拡張13例(54.2%),上皮の幼若化14例(58.3%)の所見が比較的高頻度であり,NSAID起因性消化管病変のうち小腸のみに認められる所見としては偽幽門腺化生を2例(8.3%)に認めた.アポトーシス小体については13例(54.2%)にみられたが合計切片上の出現個数は2個以下と少ないものが9例(69.2%)と多く,この組織所見のみからの確定診断は困難と思われた.NSAID起因性小腸病変の組織診断に際しては他の炎症性疾患の除外が重要であり,より明確な診断のためには多くの鑑別疾患の把握と詳細な臨床情報を加味することが肝要と考えられた.
We reviewed the histological features of NSAID(non-steroidal anti-inflammatory drug)-induced small intestinal lesions using biopsy specimens from 24 cases. Histopathological examinations revealed non-specific, mild and/or mild to moderate, and focal inflammatory infiltrates in all cases. The findings of congestion or edema, dilatation of lymphatics, and young epithelium are observed in more than fifty percent of cases. Apoptotic bodies are shown in thirteen cases(54.2%), but the number of apoptotic bodies are very few, so making a definite diagnosis is difficult using only this finding. We concluded that, having ruled out other specific forms of inflammation and the combination of clinical information and guidelines for differential diagnosis are essential to make a definite diagnosis of NSAID-induced small intestinal lesions.
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