胃IFPの経過観察例

Follow-up Observation of Gastric Inflammatory Fibroid Polyp, Report of a Case

要旨●患者は70歳代，女性．検診の上部消化管X線造影検査で胃に異常所見を指摘され，EGDを施行した．胃前庭部大彎に15mm大の急峻な立ち上がりのくびれを有するSMT様隆起を認めた．隆起の頂部に発赤陥凹を有しており，同部位から生検を施行したが診断には至らなかった．3年後のEGDで増大傾向であったため，診断的治療としてESDを施行し，胃IFPと診断した．IFPは生検により確定診断が得られることは少なく，増大傾向を示すなど悪性腫瘍の可能性が否定できない場合には，診断的治療として内視鏡治療あるいは外科治療を考慮する必要がある．

　Upper gastrointestinal radiographic screening performed in a woman in her 70s showed abnormal findings in the stomach. An EGD（esophagogastroduodenoscopy）revealed a 15-mm, sharp, rising submucosal tumor with constriction at the grater curvature of the stomach. We could not establish a definite diagnosis using the specimens collected from the reddish depression at the top of the lesion. An EGD performed after 3 y showed that the lesion had grown in size ; therefore, endoscopic submucosal dissection was performed, and the lesion was diagnosed as an IFP（inflammatory fibroid polyp）. A definite diagnosis of IFP is rarely achieved with biopsy ; therefore, endoscopic or surgical resection is required when malignancy cannot be ruled out.