粘膜下腫瘍様の食道表在癌の内視鏡診断

Endoscopic Diagnosis of Superficial Esophageal Cancer with the Appearance of Submucosal Tumor

要旨　粘膜下腫瘍様の食道表在癌として，未分化癌，腺様囊胞癌，類基底細胞癌，腺扁平上皮癌，が挙げられ，腺癌，扁平上皮癌の中にも同様の形態をとるものがある．ごくまれなものとしてはカルチノイド，平滑筋肉腫，転移性腫瘍もある．これらの内視鏡診断を行うには，ヨード染色，トルイジンブルー染色を併用して，①上皮内伸展の有無，②腫瘍の立ち上がり，③表面の凹凸，④被覆粘膜上皮の厚さ，⑤中央陥凹の性状，をみる必要がある．粘膜下腫瘍様の形態をとる食道表在癌の内視鏡による鑑別診断について詳細に述べた．

　The superficial esophageal cancer with the appearance of submucosal tumor include small cell type undifferentiated carcinoma, adenoid cystic carcinoma, basaloid carcinoma and adenosquamous carcinoma as well as some cases of adenocarcinoma and moderately differentiated or poorly differentiated squamous cell carcinoma. Carcinoid tumor, leiomyosarcoma and metastatic carcinoma can show the similar appearance but rarely.

　For the endoscopic diagnosis of these submucosal type of superficial carcinoma in esophagus, iodine staining and toluidine blue staining are useful. The important points to observe the lesion are as follows; ① existence of intraepithelial spread or not, ② the shape of protrusion the tumor, ③ irregular of the tumor surface, ④ the thickness of the covering epithelium, ⑤ the features of the central depression.

　We described in detail on the differential diagnosis of the superficial esophageal cancers with the appearance of submucosal tumor.