胃壁内迷入膵の病理組織所見

Histopathological Findings of the Aberrant Pancreas in the Gastric Wall

　膵組織の胃壁内迷入に関しては多くの文献があるが剖検胃に偶然見出されたものの報告およびその統計的観察が主体をなしている(表1)．

　近時診断法の進歩により，胃粘膜上の小病巣をも検出することが可能になり，粘膜下腫瘍の診断の下に迷入膵病変による胃の切除例が増加しっつある．

　筆者らは過去17年間の切除胃の組織検査から25例の該当例を得ているので，これらの例について病理組織学的所見およびその特徴等について述べ今後の治療指針の参考に供したい．

1. Aberrant pancreas was found in 25 (0.25%) aut of 10,066 cases of gastrectomy performed at Yokoyama's Hospital for Gastrointestinal Diseases during the past 17 years.

2. Of these 25 cases, 16 were male and 9 female. Average age of the patients was 43.9 years.

3. Fifty six per cent of aberrant lesions were found in the antrurn adjacent to the pyloric ring. In only one case the lesion was located on the anterior wall near the lesser curvature.

4. Gross appearances of the aberrant pancreas were classified into 3 types: hemispheric, shallow ulcer or scarred ulcer type and hypertrophic fold types. Their frequency was 80%, 8% and 4%, respectively. The remaining 8 per cent had no remarkable macroscopical changes.

5. On the basis of relative amount of components the aberrant pancreas was histologically classified into the following 3 types: acinar, ductar and mixed types.

6. Main locus of the acinar type was in the submucosa (75%), while that of ductar type was in the rnuscularis propria (75%).

7. The aberrant pancreas, when located in the muscularis propria, was accompanied by hypertrophy of the surrounding muscles.

8. Langerhans islet was seen in 36%. Acinar type located in the mucosa was seen in 24%.