胃・十二指腸アミロイドーシスのX線・内視鏡診断

Roentgenologic and Endoscopic Appearances of Amyloidosis Involving the Stomach and Duodenum

要旨　これまでに，われわれの経験した全身性アミロイドーシスのうち，胃・十二指腸にアミロイドの沈着がみられた8症例を対象として，X線・内視鏡検査における胃・十二指腸の特徴的所見を調べた．また，生検および剖検組織標本におけるアミロイドの沈着程度から，X線・内視鏡像に反映される所見についても検索を行った．更に，わが国の文献から胃・十二指腸アミロイドーシスの30症例を収集し，自験例8症例を加えた38例より，日本人の胃・十二指腸アミロイドーシスのX線・内視鏡検査所見を検討した．その結果，本疾患にのみ出現する特徴的所見というものは存在しなかったが，アミロイドの沈着の程度に応じて消化管の壁や粘膜に何らかの変化が認められた．これらの所見はX線所見よりも，内視鏡所見のほうに多く認められた．

　Roentgenologic and endoscopic appearances of the stomach and duodenum were studied in eight patients with systemic amyloidosis involving the gastroduodenal tract. Correlative studies were performed to see whether it reflected the pathological amyloid deposition in the stomach and duodenum or not.

　In addition, 30 Japanese cases with amyloidosis of the stomach and duodenum were collected from medical journals giving case presentations. From a total 38 cases, the characteristic appearances which were shown in the roentgenologic and endoscopic examinations were also investigated.

　As a result of our investigations, we could not identify any conditions or signs specifically indicative of amyloidosis. However, we were able to observe certain lesions of the stomach and duodenum which, though unspecific of amyloidosis, varied according to the degree of amyloid deposition. Such lesions were more frequently observed in endoscopic examination than in roentgenologic examination.