咽頭・頸部食道領域の病理診断

Pathological Dignosis of Pharygealand Esophageal Lesions

要旨　近年，内視鏡機器および手技の発達とともに，咽頭領域の詳細な観察が可能になってきており，咽頭領域の肉眼観察とその病理診断においても診断精度向上や詳細な症例解析が要求されつつある．咽頭・口腔・頸部食道領域において，悪性腫瘍の組織型は扁平上皮癌が大部分を占める．しかし，各癌取扱い規約における浸潤様式の記載は，一様ではない．そこで，今回筆者らは，咽頭癌・頸部食道癌・口腔癌の外科切除材料を比較検討し，その浸潤様式の差異を示した．加えて，咽頭領域・頸部食道領域にみられる良性疾患（乳頭腫・グリコーゲンアカントーシス・異所性胃粘膜など）について解説した．

　Recent advances in endoscopic technology and methodology have enabled the observation of the pharyngeal and cervical esophageal regions. Therefore, we have to make efforts for improving diagnostic levels and case analyses of the various pharyngeal and cervical esophageal lesions. In this paper, we describe histopathological differences among pharyngeal, esophageal and oral cancers. These cancers are mainly composed of differentiated squamous cell carcinoma, but show different patterns of tumor growth and stromal invasion. We also mention various benign lesions, such as papilloma, glycogen acanthosis, ectopic gasric mucosa of pharynx and cervical esophagus.