十二指腸上皮性腫瘍の病理組織学的特徴

Superficial Non-ampullary Duodenal Epithelial Tumors: Histopathological Features

要旨●表在性非乳頭部十二指腸上皮性腫瘍33例33病巣の病理像と細胞形質について検索した．その結果は以下のように要約された．近位十二指腸（第1〜2部）には，腸型形質腫瘍の他，胃型形質腫瘍も発生し，後者の周囲粘膜には胃腺窩上皮化生や異所性胃粘膜が観察された．腺腫と腺癌はいずれも半球状または扁平な隆起を形成し，平均腫瘍径は約15mmであった．主な組織型は軽度〜中等度異型の管状腺腫と高分化腺癌であった．以上の特徴を指摘し，若干の病理学的考察を加えた．

　The aim of this study was to elucidate the histopathological features of superficial non-ampullary duodenal epithelial tumors（SNADET）in a single-center case series. We studied 33 lesions from 33 patients with SNADET, including 19 adenomas and 14 adenocarcinomas, which were endoscopically resected from 2004 to 2016. Results showed that not only intestinal-type tumors but also gastric-type tumors were located in the first and second parts of the proximal duodenum. Gastric foveolar epithelial metaplasia and heterotopic gastric mucosa were exclusively recognized adjacent to the gastric-type adenocarcinomas. Macroscopically, all cases showed sessile（broad based）or slightly elevated lesions. Mean tumor diameter was 15mm. Tubular adenoma with mild-to-moderate cytological atypia and well-differentiated adenocarcinoma were common histological types in our case series.