胃・十二指腸・空腸に多発性ポリープが発見された家族性大腸ポリポージスの2例

Two Cases with Familial Adenomatosis of the Colon, Associated with Multiple Polypoid Lesions of the Stomach, Duodenum and Upper Jejunum

　家族性大腸ポリポージスは大腸にびまん性に無数の腺腫が発生し，しかもそれらが高率に癌化する遺伝性疾患として知られている．しかし最近，胃病変^1)～3)，潜在性顎骨腫様病変⁴⁾および十二指腸病変³⁾⁵⁾⁶⁾が本症に極めて高率に合併することが報告され，本症を大腸の限局性疾患としてきた従来の考え方は改められつつある．われわれは胃・十二指腸のみならず，文献上極めて報告の少ない空腸にまで多発性ポリープが発見された本症2例を報告し，若干の文献的考察を加える．

　Two cases with familial adenomatosis of the colon (polyposis coli), associated with multiple polypoid lesions of the stomach, duodenum and upper jejunum are described in reference to those reported in the literature.

　Case 1 (negative family history):

　A 41-year-old woman had suffered from diarrhea and weight loss for several months.

　Gastric X-ray examination revealed numerous polypoid lesions in the gastric body and antrum, suggesting that she might have polyposis coli, which was proved by barium enema. Upper GI series and endoscopic examinations demonstrated multiple polypoid lesions in the stomach as well as duodenum and jejunum.

　Histological studies of the biopsy specimens from polypoid lesions of the gastric body showed the fundic mucosal hyperplasia with cystic dilatations. On the other hand, all specimens from the gastric antrum, duodenum and jejunum disclosed that these poly poid lesions were adenoma in origin.

　Case 2 (positive family history):

　A 26-year-old man had a history of partial gastrectomy for duodenal ulcer in 1969. Upper GI series and endoscopic examinations revealed multiple small polypoid lesions in the remaining stomach, duodenum and upper jejunum. Polypoid lesions in the unresected part of the stomach were shown to be fundic mucosal hyperplasia, whereas those of the duodenum and jejunum were adenomas.

　Both patients had total colectomy. Resected specimens of the colon showed a typical picture of poly-posis coli associated with advanced cancers.