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Stomach and Intestine(Tokyo) Volume 10, Issue 4 （April 1975）

胃と腸 10巻4号（1975年4月発行）

Japanese English

今月の主題症例・研究特集

症例

若年性大腸ポリポーシス（Juvenile polyposis coli）の1例 Juvenile Polyposis Coli, Report of a Case 武藤徹一郎 ¹ , 原宏介 ¹ , 堀江良秋 ¹ , 喜納勇 ² , 三輪徳定 ³ , 宇都宮譲二 ⁴ , 青木望 ⁵ T. Muto ¹ , Y. Horie ¹ , I. Kino ² , J. Utsunomiya ⁴ , N. Aoki ⁵ ¹東京大学医学部第1外科 ²東京大学医学部病理学科 ³三輪病院 ⁴東京医科歯科大学医学部第2外科 ⁵東京医科歯科大学医学部病理学科 ¹Dept. of Surgery, University of Tokyo ²Dept. of Pathology, Uriversity of Tokyo ⁴Dept. of Surgery, Tokyo Medical and Dental University ⁵Dept. of Pathology Tokyo, Medical and Dental University pp.491-497

発行日 1975年4月25日 Published Date 1975/4/25

DOI https://doi.org/10.11477/mf.1403112299

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Abstract 文献概要
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　1955年以来の教室の大腸ポリープを組織学的に検索している間に，若年性大腸ポリポーシス（Juvenile polyposis coli）と考えられる稀有なる症例を見出し，術後18年後の経過観察を行なうことができたので，ここに組織学的特徴を中心に報告する．

　This report is to present an example with juvenile polyposis coli, followed up 18 years after the first operation.

　Case history: A 16 year old boy was referred to Tokyo University Hospital complaining of rectal prolapse and severe anal bleeding since the age of 6. Barium enema showed multiple polyps throughout the colon with the highest density in the rectum. Abdominoperineal resection and colostomy was performed. The surgical specimen showed multiple polyps of the sigmoid colon and innumerable polyps with variable size and shape of the rectum. The polyps consist of increased tubules lined by normal colonic cells with much cystic change surrounded by an excess of lamina propria. Although there are foci resembling adenomatous tubules with occasional Paneth-like cells in large polyps, the appearances are consistent with those of juvenile polyposis coli, first described by McColl et al. Lymphoid hyperplasia in the lamina propria and submucosa was prominent. Total colectomy and ileostomy was performed 2 years later because of persistent bleeding. The removed colon had numerous polyps in the cecum and multiple polyps scattered in the ascending and transverse colon. The histology of the polyps showed the same characteristics as those of the rectal polyps. At the age of 34 he was examined by gastroscope and colonoscope, and no polypoid lesions were found in the stomach and the terminal ileum. No members of his family so far had shown any symptoms suggesting colonic disease. Physical examination revealed no congenital abnormality.

　This case is believed to be the 1st reported case of juvenile polyposis coli with a definite histological evidence in Japan and 26 th unequivocal case in the world literature including generalized juvenile gastrointestinal polyposis. The world literature was reviewed and clinical management was discussed.