家族性大腸ポリポージスの十二指腸病変

Duodenal Lesions in Familial Polyposis of the Colon

　家族性大腸ポリポージスは大腸に無数の腺腫が発生し，しかも高率に癌化する遺伝性疾患として知られている¹⁾．最近，本邦では本症の歯牙および胃にも高率に腫瘍性病変が合併することが報告され^2)～4)，本症に骨腫，軟部腫瘍を合併したGardner症候群と本症は本質的には同じものであるとする意見が強い．

　われわれも本症においては胃のみならず十二指腸にも腫瘍性病変が認められることを報告した⁵⁾．その後さらに症例を重ね，本症の十二指腸に精密なX線検査，内視鏡検査，生検を施行した結果，本症の92％に腺腫を認めた．

　The duodenum was thoroughly examined by hypotonic duodenography and duodenoscopy in 13 patients with familial polyposis of the colon. Solitary or multiple polyps were recognized in 12 out of the 13 cases. Most of polyps were located in the second portion of duodenum.

　Solitary polyp was large enough to be visualized by hypotonic duodenography, but multiple polyps were too small to be demonstrable by duodenography. But they were easily recognized by duodenoscopy. In 12 of 13 cases, the histological feature of the duodenal polyp was adenoma.

　Six out of seven cases with multiple duodenal polyps had colonic polypoid lesions of high density and solitary or multiple polypoid lesions in the stomach, whereas five cases which had solitary or relatively fewer duodenal polyps showed colonic polypoid lesions of low density. In four of these no gastric polypoid lesions were found.

　From the results obtained, it is considered that “familial polyposis of the colon” frequently affects not only the stomach but also the duodenum. Therefore it would be better to term the disease as “familial polyposis of the gastrointestinal tract” rather than “familial polyposis of the colon”