食道良性腫瘍および腫瘍様病変の病理

Pathological Characteristics of Benign Tumors or Tumor-like Lesions of the Esophagus

要旨●代表的な食道良性腫瘍および腫瘍様病変について臨床病理学的所見を提示するとともに，文献的にも検討し病変の特徴を概説した．これらの病変の中で，臨床的に嚥下時のつかえ感や嚥下困難をきっかけに発見される場合，悪性腫瘍との鑑別が問題となる．一方，乳頭腫のように無症状で内視鏡検査で発見され，積極的な治療を要さない疾患もある．肉眼的には粘膜下腫瘍として認識される病変，内腔に突出する病変，壁在に存在する病変に大別される．それぞれの臨床病理学的特徴を知っておくと，鑑別診断の助けになる．また，これらの病変の中には，悪性腫瘍や遺伝性疾患との関連や併存が知られているものもあり，良性病変という判断だけではなく，他の疾患との関連にも注意を払うべきである．

　We present the clinicopathological features of benign esophageal tumors and tumor-like lesions and explain their characteristics by reviewing the literature. When these lesions are found clinically, due to a feeling of swallowing or difficulty in swallowing, it is crucial to differentiate benign lesions from malignant tumors.In contrast, there are also asymptomatic diseases, such as papillomas, that are incidentally found by endoscopy and do not require active treatment. Macroscopically, esophageal lesions are classified into three groups：submucosal tumors, lesions protruding into the lumen, and lesions present in the esophageal wall. Knowledge of the clinicopathological characteristics of each lesion could aid in differential diagnosis. Furthermore, some of these lesions are associated with malignant tumors or hereditary diseases ; hence, attention should be paid not only to the diagnosis of benign lesions but also to their relationship with other diseases.