食道の非腫瘍性ポリープの内視鏡所見

Endoscopic Findings of Non-neoplastic Esophageal Polyps

要旨●食道の非腫瘍性ポリープに関して文献的考察を含めて解説を行った．化膿性肉芽腫（PG）は発赤調の隆起性病変で白苔を伴うことが多く，時に潰瘍を併発する．炎症がその成因と考えられ，短期間に増大したり縮小したりする．血管線維性肉芽腫（FVP）は下咽頭〜頸部食道に基部を有するソーセージ様の大型の有茎性ポリープである．支持組織の乏しい粘膜が蠕動などにより牽引されることで徐々に増大すると考えられ，表面は正常の扁平上皮で覆われ，時に潰瘍を併発する．炎症性線維性ポリープ（IFP）は食道胃接合部が好発部位で，正常の粘膜に覆われたSMTの様相を呈し，増大するに従い有茎性やびらん，潰瘍などの所見が加わる．炎症性食道胃接合部ポリープ（IEGP）は食道胃接合部にみられる炎症を背景に持つ過形成性ポリープである．表面は比較的整った絨毛構造で，部位によっては扁平上皮に覆われている．PPIを投与することで縮小や消退する場合がある．

　Hereinafter, I have described the presentation of certain nonneoplastic polyps of the esophagus based on a literature review.

　Pyogenic granulomas are red, protruded lesions that are often furred and may undergo ulceration. These lesions can grow rapidly before stabilizing in size. Although there is no clear etiology, inflammation has been proposed as the cause of these lesions. FVP（fibrovascular polyps are large, sausage-like, pedunculated polyps, which may occur in a variety of sites from the hypopharynx to the cervical esophagus. It is presumed that the gradual increase in size of fibrovascular polyps occurs due to the mucosal layer being pulled by forces such as those generated by peristaltic movements of the esophagus. FVP are covered with normal squamous epithelium and may be associated with ulcers. Inflammatory fibroid polyps tend to develop in the esophagogastric junction. They have a submucosal tumor phase in which they are covered with normal mucosa and may become pedunculated, eroded, or ulcerous as they grow. IEGP（inflammatory esophagogastric polyps）are hyperplastic polyps arising from inflamed tissue in the esophagogastric junction. The surface of such polyps can have a relatively organized villous structure partly covered with squamous epithelium. IEGP may decrease in size or disappear after the administration of proton pump inhibitors.