ポリペクトミーにより組織学的に証明されたアミロイド沈着による直腸ポリープの1例

Amyloidosis Localized in the Small Rectal Polypoid Lesion, Report of a Case

要旨　左下腹部痛を主訴として来院した50歳の男性に，注腸検査で直腸に7mm大の隆起性病変を発見し，ポリペクトミーを行った．組織学的検索の結果，粘膜固有層に結節状に沈着したアミロイドにより隆起が形成されていた．全身的な検索では，その他の諸臓器にはアミロイドーシスによる症候を認めなかった．また，消化管の他の部位よりat randomに採取した生検組織にはアミロイドの沈着を認めなかった．この結果，直腸の小隆起に限局する非常にまれな限局性のアミロイドーシスの1型と考えられた．

　A case of rectal amyloidosis was reported. In this case, amyloid deposition was localized only in a small rectal polyp. The patient was 50 years old man with the complaint of occasional left lower abdominal pain. Barium enema examination showed a 7 mm small polyp in the upper segment of the rectum. Endoscopic polypectomy was performed. Pathohistological examination revealed that the polyp was composed of nodularly accumulated amyloid in the lamina propria. Additional x-ray examination of the entire GI-tract revealed no findings characteristic for amyloidosis and only a small submucosal tumor was found in the jejunum. No clinical symptoms suggesting amyloidosis existed either. Although the submucosal tumor in the small intestine was not pathologically examined, we consider that this is a very rare case of intestinal amyloidosis.