粘膜下腫瘍と臨床的に診断された小さな胃癌の1例

Small Gastric Cancer Clinically Diagnosed as Submucosal Tumor, Report of a Case

要旨　胃底腺粘膜領域にみられた粘膜下腫瘍様病変を内視鏡的にポリペクトミーした．術前は胃底腺ポリープ，あるいは小さな平滑筋腫などの粘膜下腫瘍との鑑別は困難であったが，組織学的には粘膜下層に発育し異所性粘膜に発生した高分化型腺癌であった．しかしこれは粘膜筋板を伴う固有粘膜が粘膜下層に反転（invert）し，その粘膜内にのみみられた早期癌と考えられた．

　Endoscopically we polypectomized a submucosaltumor-like lesion in the area of the gastric fundic gland mucosa. Before polypectomy, it was hard to differentiate the lesion from a fundic gland polyp or a submucosal tumor such as a small leiomyoma. It was pathologically diagnosed as a well differentiated adenocarcinoma derived from ectopic gastric mucosa grown up in the submucosal layer. But it was considered as an early gastric cancer localized in inverted mucosa in the submucosal layer.