主題 隆起を主体とする上皮性病変の特徴と鑑別

Characteristic Features and Differential Diagnosis of the Rare Epithelial Protruded Lesions of the Esophagus

要旨●食道腫瘍の大半は扁平上皮癌であり，その他の組織型の腫瘍/腫瘍様病変の頻度は総じて低い．本稿では，隆起を主体とするまれな上皮性病変として，verrucous carcinoma，腺癌，癌肉腫，神経内分泌腫瘍，神経内分泌細胞癌，腺様囊胞癌，悪性黒色腫，転移性腫瘍，食道腺腫，扁平上皮乳頭腫および炎症性ポリープを取り上げ，それぞれの特徴と鑑別すべき疾患を概説する．日常臨床で遭遇する機会は少ないが，報告例の特徴を記憶し，鑑別すべき疾患として念頭に置くことが，診断の一助になると思われる．

　Most esophageal tumors are SCCs（squamous cell carcinomas）. The incidence of tumors and tumor-like lesions other than SCC is low. This paper covers the following rare epithelial protruded lesions of the esophagus: verrucous carcinoma, carcinosarcoma, adenocarcinoma, adenoid cystic carcinoma, neuroendocrine tumor（G1 or G2）, neuroendocrine carcinoma, squamous cell papilloma, adenoma, inflammatory polyp, and malignant melanoma. Differential diagnosis and characteristic features of each lesion are reviewed. Although these lesions are rare, it will be helpful to memorize their reported features in the differential diagnosis of esophageal lesions.