胃海綿状血管腫の1例―殊にその切除胃血管造影所見

Cavernous Hemangioma of the Stomach with Special Reference to Angiographic Findings of Resected Specimen, Report of a Case

　胃の血管系腫瘍はまれとされ，本邦でもその報告は少数散見されるのみである^1)～6)．これら腫瘍の術前の血管造影所見を報告した例は少数認められる⁴⁾⁷⁾⁸⁾が，術後切除胃において血管造影を施行した症例はまだ見当たらない．

　今回，われわれは術前内視鏡検査にて胃血管腫と診断され術後の組織診断にて海綿状血管腫と診断された1症例について，胃切除後血管内に造影剤を注入し腫瘍の血行動態を検討し若干の興味ある知見を得たので報告する．

　Angiography of the resected specimen of cavernous hemangioma of the stomach from a 73-year-old woman was performed and compared with histological findings. The following results were obtained.

　1) The tumor located in the anterior wall of the body of the stomach was dark red, strawberry-like and 6×6 cm in diameter, occupying almost the entire layers of the gastric wall. The overlying gastric mucosa appeared almost normal

　2) The tumor tissue consisted of various irregular cavities, in which little contrast medium was observed. This strongly suggested that the tumor was hypovascular rather than hypervascular angiographically.

　3) Irregular, nodular pieces of contrast medium were noted scattering in these cavities near or adjacent to the mucosal layer.

　4) The continuity of these cavities with capillary vessels of the normal mucosa was occasionally found, but direct connection with arteries could not be detected.

　From these results, it is reasonable to assume that cavernous hemangioma has much connection with capillary vessels and little, if any, with arteries; that most of the tumor tissue is isolated from the surrounding normal vessels and blood stream in the tumor is stagnant and also that angiographic diagnosis of cavernous hemangioma is quite difficult before the operation.