独特なpatternを示したGastritis polyposa症例

Gastritis Polyposa Showing a Characteristic Pattern, Report of a Case

　最近，私どもは独特なパターンを示す胃ポリポージスを経験した．はじめにX線検査で胃細網肉腫を疑い，内視鏡で，びらん性胃炎と診断し，生検は陰性で，繰り返す洗浄細胞診で過形成性胃炎の典型的剝離細胞像を認め，良性と考えたが，既往に吐血があるため手術を施行した症例である．その肉眼標本，および組織標本を検討して改めてX線および内視鏡所見を反省し，興味ある知見を得たので報告する．

　A recently encountered case of gastritis polyposa displaying a peculiar pattern is described.

　The patient, a 57-year-old woman engaged in farming, became very fond of habitually eating heavily flavored Korean pickles since about five years before. She was also said to drink about a pint of sake at supper. Recently she had a bout of hematemesis on a sudden, so that she visited us complaining of abdominal distension and loss of appetite.

　The initial roentgenography led us to suspect reticulum cell sarcoma of the stomach, but subsequent endoseopy revealed a picture of erosive gastritis. Biopsy was negative for cancer. Repeated lavage cytodiagnostic procedure also disclosed a typical picture of cell exfoliation seen in hyperplastic gastritis. Nonetheless, previous hematemesis was duly taken into consideration, and operation was performed.

　The present case was characterized by the sash-like distribution in its develoment in the fundic gland area close to that of the pyloric gland. Roentgenography and endoscopy likewise portrayed its peculiar distribution pattern as excellently as in gross observations. Its developmental mechanism seemed to lie in the repetition and recrudescence of erosions with resultant hyperplasia of regenerating epithelia for their repair. Non-tumoral polyposis, it should be called, developing in the intermediate zone between the enlarged pyloric gland area which was very atrophic and the area of the fundic gland. So-called gastritis polyposa was exem exemplitied lified in this case.