多発性十二指腸嚢胞の1例

Multiple Duodenal Cysts, Report of a Case

要旨　患者は62歳，男性．十二指腸潰瘍の内服治療中に，X線および内視鏡検査で十二指腸下行脚に隆起性病変を2個認めたため，当科入院となった．いずれの病変も表面平滑，正色調で軟らかく，表面粘膜の生検では炎症性細胞の浸潤した十二指腸粘膜であった．更に超音波内視鏡検査で粘膜下層に限局した低エコー病変として描出されたため，粘膜下嚢胞の診断で内視鏡下に穿刺吸引を行った．嚢胞内容物の細胞診ではBrunner腺上皮細胞が認められ，Brunner腺嚢胞と診断した．自他覚所見がなく，良性の嚢胞であることが明らかであったため，内視鏡的切除は行わなかった．

　A 62-year-old Japanese male, who had had a duodenal ulcer for four years, was admitted to our hospital for examination of elevated lesions in the duodenum. Upper gastrointestinal series revealed two filling defects, 2 cm in diameter, in the second portion of the duodenum. Endoscopic findings revealed a duodenal ulcer and two smooth-surfaced hemispherical polypoid lesions which were normal in color. These lesions were soft and covered by the duodenal mucosa with chronic inflammation. Endoscopic ultrasonography suggested duodenal cysts. Aspirate of these cysts contained many Brunner's gland epithelial cells with infiltration of inflammatory cells, chiefly neutrophils.