胃粘膜下腫瘍の病理診断

Pathologic Diagnosis of Gastric Submucosal Tumors

要旨●胃粘膜下腫瘍の基本形は，病巣の主座を粘膜下層に置き，周囲粘膜と同様の粘膜によって被覆された，半球状ないし球状の隆起である．胃粘膜下腫瘍は良性から悪性までさまざまな病型・組織型を包括している．実臨床では，粘膜下腫瘍の良・悪性の診断が要求されるが，少量の生検組織では診断に苦慮する．病理医は肉眼形態や臨床情報を参考にしつつ，免疫染色などの補助手段を併用し，病理診断の精度向上を目指す一方で，臨床家は挫滅のない良質かつ十分量の組織を採取することが重要である．

　Gastric submucosal tumors are commonly encountered by pathologists, and can pose considerable problems in histopathologic diagnosis, especially small-sized biopsy specimens with artifact. The basic form of gastric submucosal tumor is defined as the semi-spheroid or spheroid tumor elevated into the lumen and covered with surrounding gastric mucosa. Gastric submucosal tumors are originated from benign or malignant lesions. In clinical practice, it may be necessary to request differentiation of benign lesions from malignant lesions. Correlation of gross pathological findings with a clinical information and results of ancillary studies, such as immunohistochemistry and genetic analysis, may be helpful in differentiating benign lesions from malignant lesions. For clinicians, it is important to bear in mind ideal tissue sampling.