病理からみた消化管の悪性病変と皮膚病変

Histopathological Study of Gastrointestinal Lesions with Skin Manifestations

　内臓病変と皮膚病変が密接に関係することはよく知られている．これに対してdermadrome，vicero-cutaneous syndrome, skin manifestation of gastro-intestinal disorderなどの言葉が用いられている．

　このうち本稿では消化管の悪性腫瘍と皮膚病変に焦点を絞った．更にこの中でも，われわれが比較的多くの症例を持っている，Peutz-Jeghers（以下P-Jと略）症候群と家族性大腸腺腫症について，前者に対しては癌化の問題を，後者に対しては皮膚病変の特徴を，検討した．

　We examined problems on malignant transformation in Peutz-Jeghers polyps and on characteristics of skin and soft tissue tumors in familial adenomatosis coli, using cases shown in Table 1.

　Six (22％) of twenty-seven patients with Peutz-Jeghers syndrome or Peutz-Jeghers type polyp had advanced carcinomas or carcinoma in Peutz-Jeghers (type) polyps. Rate of malignant change of the polyps showed a positive correlation with the size of the polyps. It seems to be the most frequent route to malignant change that the carcinoma originates from adenoma occurred in the Peutz-Jeghers (type) polyps.

　Twelve (35％) of thirty-four patients with familial adenomatosis coli revealed skin and soft tissue tumors which were all benign in nature (epidermoid cyst, pilomatrixoma, fibroma, lipoma, fibrolipoma, angiolipoma and desmoid tumor). Frequency of desmoid tumor was high (3.5％) compared with that in general population.