回盲弁に限局した良性リンパ濾胞性ポリープの1例

Benign Lymphoid Polyps of the Ileocecal Valve, Report of a Case

要旨　患者は，66歳，男性．4年前に直腸カルチノイドを内視鏡的に切除した．その経過観察を目的とした大腸内視鏡検査で，回盲弁に異常を認め，精査目的で入院．大腸X線検査では回盲弁に小隆起が密集し，また内視鏡検査でも同部に発赤した小隆起が多発していた．小隆起の一部を内視鏡的に切除し，その病理組織学的検索の結果，隆起は回盲弁上皮に覆われた良性のリンパ濾胞増殖により形成されていた．以上から，良性リンパ濾胞性ポリープと診断した．本例は回盲弁に限局した良性のリンパ濾胞過形成であったが，上皮性腫瘍との鑑別を要した．また，内視鏡的ポリペクトミーがその診断上有用であった．

　A 66-year-old man who had previously undergone endoscopic removal of rectal carcinoid was admitted because of polypoid lesion of the ileocecal valve on follow-up colonoscopy. Radiographic examinations revealed multiple polypoid masses on the ileocecal valve, and endoscopic examinations revealed multiple reddish polypoid lesions. A polypoid mass was resected endoscopically and was investigated histologically. Pathologic examinations showed that a polypoid mass consisted of benign proliferation of lymph follicle. The patient was diagnosed as having benign lymphoid polyps localized in the ileocecal valve. In this case, epithelial neoplasm should be included in the differential diagnosis. Endoscopic resection was useful to diagnose this condition.