炎症性腸疾患と鑑別が必要な腫瘍および腫瘍様病変

Tumors or Tumor-like Lesions that Are Difficult to Differentiate from Inflammatory Bowel Disease

要旨●炎症性腸疾患に類似した形態を呈し，時に鑑別を要する腫瘍および腫瘍様病変としては，4型大腸癌，悪性リンパ腫，腸管子宮内膜症，潰瘍性大腸炎関連腫瘍，転移性大腸癌などが挙げられる．いずれも遭遇する頻度は低いが，診断に苦慮することがある．疾患の病態や特徴を理解したうえで，内視鏡検査だけでなく，注腸X線造影検査やCTも用いて病変を多角的に捉え，臨床症状や経過も踏まえて診断する必要がある．

　Inflammatory bowel disease can sometimes be difficult to differentiate from tumors or tumor-like lesions such as those found in diffuse invasion-type colorectal cancer, malignant lymphoma, intestinal endometriosis, ulcerative colitis-associated neoplasia, and metastatic tumor. Accurate diagnosis can be obtained by evaluating the disease by colonoscopy as well as enema contrast examination, computed tomography, and clinical symptoms and clinical course.