0-IIa+IIc型から0-Ip+IIa+IIc型に発育した食道表在癌の1例

A Mucosal Cancer of the Esophagus with Superficial and Slightly Depressed Lesion (0-IIa+IIc) which Developed into Superficial Protruding Lesion (0-Ip+IIa+IIc), Report of a Case

要旨　患者は54歳，男性．健診目的にて行った上部消化管内視鏡検査にて病変を指摘された．初回内視鏡検査では切歯列から30～40cmの全周にわたる0-IIc型病変と，その中に顆粒状隆起を認め，35cmの後壁には0-IIa型病変を認めた．初回内視鏡検査から約68日目に再度内視鏡検査を施行したところ0-IIa型と考えられていた病変が径2cm大の0-Ip型に発育していた．深達度は内視鏡検査でsm2，食道造影検査でm3～sm1と診断し，食道切除術を施行した．病理組織診断の結果は70×62mm大の0-Ip+IIa+IIc型食道癌，深達度m3，低分化型扁平上皮癌，ly0，v1，n0，0-IIc病変の中の隆起成分が上方発育した形の発育進展形式であった．

　A-54-year old man was admitted to our hospital because of abnormalities of the esophagus. He had been doing well until esophageal abnormalities were found during an annual check up of the upper gastrointestinal endoscopy. A superficial and slightly depressed lesion (type 0-IIc) at the middle and lower third of the esophagus with a small slightly elevated lesion (type 0-IIa). The type 0-IIa lesion developed into superficial and protruding lesion (type 0-Ip) . Histological study on bite biopsies revealed squamous cell carcinoma. Clinical estimation strongly suggested slight invasion into the submucosa and probability of lymph node metastasis. A radical esophagectomy was carried out. Pathological studies on the resected specimen revealed that carcinoma of the lower esophagus was a type 0-Ip + IIa + IIc lesion measuring 70 X 62 mm in size. It was a poorly differentiated squamous cell carcinoma, Tla (m₃), ly₀, v₁, n₀.