大腸絨毛腫瘍（腺管絨毛腺腫）の形態的検討―特に小病変について

Clinical Study on Villous Tumors of the Large Intestine with Special Reference to Small Lesions

要旨　絨毛腺管に着目し，良悪性を問わず腺管絨毛腺腫までを含めた32病変を絨毛腫瘍としてその形態を検討した．①絨毛様突起を有する典型例8病変，②絨毛様突起を有していないが，広基性で，腫瘤表面の結節は大きく，微細な凹凸不整・発赤を伴い，イモ虫様・脳回転様・八つ頭様といった特異の形態を呈する例5病変，③山田Ⅲ・Ⅳ型を呈し，更に表面の凹凸の目立つ例7病変，④通常の山田Ⅲ型・Ⅳ型と全く鑑別ができない例12病変，の4型に大別できた．病理組織学的に絨毛腺腫および腺管腺腫との中間型が全体に占める比を求めると，②，③では全例が大部分を占めていたが，①，④では大部分を占める例からわずかな例まで広く認められた．

　We studied 32 lesions of the tumors, irrespective of malignant or benign which contained villous glands. These lesions were divided into four types morphologically. Eight lesions were classified as the first type, a typical form of villous tumor, which had broad bases with villous fronds. Five lesions were classified as the second type, a special form of villous tumor without villous fronds. This type was characterized by knotted or fine irregular surfaces with broad bases. The third type, seven lesions were classified into, had polyps of Yamada Ⅲ or Ⅳ with fine irregular surfaces. The fourth type was the same as usual polyps of Yamada Ⅲ or Ⅳ. Histologically the tumors in the second and third types were mostly villous adenoma or intermediate glands between villous and tubular adenomas. On the other hand the proportion of villous adenoma and intermediate glands ranged widely in the first and fourth types.