経過観察中に増大傾向を認めた胃炎症性類線維ポリープの1例

Growing Inflammatory Fibroid Polyp of the Stomach which was finally Diagnosed after Endoscopic Submucosal Dissection, Report of a Case

要旨　患者は50歳代，男性．検診の上部消化管造影検査で，胃前庭部に隆起性病変を指摘されたが，生検にて悪性所見が認められなかったために近医で経過観察となっていた．6年後，病変サイズの増大を認めたことから当院に紹介され受診となった．上部消化管内視鏡検査では，なだらかな立ち上がりを有し，表面は非腫瘍粘膜で被覆されたふたコブ様の隆起性病変を認めた．6年前と比較して病変サイズは約2倍に増大を認めた．生検では確定診断に至らず，診断目的にESDを施行した．切除後の病理組織標本から胃炎症性類線維ポリープ（IFP）と診断した．経過観察中に増大傾向を認め，非典型的な内視鏡像を呈していたことにより，術前診断が困難であったと考えられた．

　The Patient was in his fifties, and presented a tumor in the antrum of the stomach in a medical check up. He was followed-up at the hospital because the pathological diagnosis was gastritis. 6 years later, the patient was referred to our hospital because the tumor had enlarged. On endoscopy, a tumor, 8mm in size, was recognized at the greater curvature of the antrum. The surface of the tumor had no irregularity nor ulceration. Neoplastic change was not detected in the tumor. We failed to reach a diagnosis by endoscopic biopsy, so ESD（endoscopic submucosal dissection）was performed. The tumor was finally diagnosed as an inflammatory fibroid polyp by an ESD specimen. In this case, diagnosis was difficult because this tumor did not have the characteristics of a typical IFP.