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要旨●H. pylori感染者の減少に伴い,活動性炎症や萎縮,腸上皮化生のない胃底腺粘膜領域に,胃型形質を示す上皮性腫瘍(胃底腺型腺癌,胃底腺粘膜型腺癌,腺窩上皮型腺癌,幽門腺腺腫など)が多くみられるようになってきた.これらの臨床病理学的特徴は広く知られているが,複雑な病理組織像あるいは細胞分化を示す腫瘍もみられるようになり,分類や鑑別診断に苦慮することがしばしばである.本稿では,これらの腫瘍の病理組織学的特徴や鑑別診断のポイントを解説し,組織分類の問題点について考察した.
As the incidence of Helicobacter pylori infection decreases, various epithelial tumors with gastric phenotype such as fundic gland type, fundic gland mucosa type, foveolar type, and pylori gland type are becoming more common in the fundic gland mucosa without active inflammation, atrophy, and intestinal metaplasia. Despite these widely known clinicopathological features, tumors with complex histology or cell differentiation have also become prevalent ; their prevalence has made classification and differential diagnosis difficult. In this paper, we explained the histopathological features of these tumors and the points of differential diagnosis. Further, we considered the problems of histological classification.
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