内視鏡診断が困難であった胃脂肪腫の1例

Gastric Lipoma in Which Endoscopic Diagnosis was Difficult, Report of a Case

要旨　患者は46歳，女性．検診の上部消化管内視鏡検査にて前庭部前壁に隆起性病変を指摘された．病変は頂部にDelleを伴っていたが，約1年10か月後の内視鏡検査にて隆起部分全体に発赤を伴う形態に変化していた．内視鏡所見では粘膜下腫瘍が疑われたが，全体に赤色調を呈し，病変は起立しておりcushion signは認めず質的診断は困難であった．腹部CT検査，超音波内視鏡検査が行われ，胃脂肪腫と診断し，内視鏡的切除を行った．

　A 46-year-old woman was found, on gastrointestinal endoscopy of examination, to have a polypoid lesion in the stomach. Endoscopy revealed the lesion with a Delle on one part of the top in the anterior wall of the antrum. About 1 year and 10 months later, however, endoscopy revealed the lesion had changed into an elevated lesion with notable flare on the top. Although the patient was referred to a nearby clinic, the lesion was suspected to be a submucosal tumor and she was admitted to this hospital. Abdominal CT and endoscopic ultrasonography were performed. The lesion was diagnosed as lipoma of the stomach. Endoscopic mucosal resection was performed. Histological findings showed that the tumor was a gastric lipoma composed of mature adipose tissue. This case was of interest because the lesion was a strange gastric lipoma that changed into another form.