Peutz-Jeghers症候群と考えられる十二指腸過誤腫の1例

Duodenal Hamartoma Compatible with Incomplete Type Peutz-Jeghers Syndrome, Report of a Case

要旨　患者は46歳男性でげっぷを主訴として来院．胃X線検査および胃内視鏡にて十二指腸下行脚に山田Ⅳ型ポリープを指摘されGIF T2にて内視鏡的ポリペクトミーを行った．腫瘤は頭部1．5×2×2cm，茎部1cm長の有茎性ポリープで表面分葉しゴツゴツしていた．組織学的には樹枝状に分枝する粘膜筋板の増殖を主体とし，全く異型を認めない小腸粘膜で覆われ過誤腫と診断された．本症例は皮膚粘膜に色素沈着を認めず，ポリープ，色素沈着の家族歴も認められないが，Gannonらの言う不完全型Peutz-Jeghers症候群と考えられた．

　A 46 year-old man was admitted to our hospital complaining of eructation. Upper gastrointestinal series demonstrated a pedunculated tumorous shadow defect at the 2nd portion of the duodenum. Endoscopic examination revealed a Yamada Ⅳ type polyp with uneven surface. Endoscopic polypectomy was performed with electrocoagulation. Tumor was measured 2×2×2.5 cm in size. Although this patient showed no mucocutaneous pigmentation nor family history of polyposis or pigmentation, histological finding disclosed a hamartomatous polyp of the duodenum. We considered this case was an incomplete type PeutzJeghers syndrome.