比較的大きな胃ポリープの1例

A Gastric Polyp of Fairly Large Size, a Case Report

　最近，胃X線検査法および内視鏡検査法の進歩に伴い，胃ポリープはかなりの高頻度で発見される様になった．しかし，ポリープと粘膜下腫瘍，およびいわゆるⅠ型早期胃癌との臨床的鑑別は必ずしも容易ではない．

　われわれは，胃X線検査，内視鏡検査で，一見粘膜下腫瘍の所見を呈し，病理組織検査で初めて胃ポリープと確診しえた1例を経験したので，報告する．

　A 56-year-old man, a company employee, had since over the past four years full sensation of the stomach after meals. As a protuberant lesion was found by x-ray in the pyloric antrum, he was advised to undergo surgical operation and visited our department.

　X-ray study of the stomach disclosed a fairly large protruding lesion in the pyloric antrum on the anterior wall with bridging folds over its margins. X-ray diagnosis was a submucosal tumor of the stomach. However, endoscopy failed to demonstrate bridging folds, although the protrusion was confirmed. Discrimination was difficult from a gastric polyp. Biopsy under direct vision enabled us to arrive at the correct diagnosis : a benign polyp of the stomach. Half of the stomach was excised.

　The polyp in the resected stomach measured 3.0×1.9 cm. It merged smoothly into the adjoining mucosa. Histologically, it proved to be a benign adenomatous polyp with atypical epithelium partially in it.

　It has been reported by many that the majority of gastric polyp measuring more than 3 cm in the greatest diameter are malignant, but our polyp still retained benign histologic findings. We have also been made keenly aware of the possible difficulty in differentiating a gastric polyp from other protruding lesions of the stomach.