胃のカルチノイド腫瘍と内分泌細胞癌の病理学的特徴—病理診断医の立場から

Histopathological Characteristics of Gastric Endocrine Neoplasms

要旨●胃の内分泌腫瘍はカルチノイド腫瘍と内分泌細胞癌に大別される．いずれも病理組織学的には悪性上皮性腫瘍（癌腫）であるが，それらの組織発生および臨床病理学的特徴は大きく異なる．それゆえに，両者は病理学的に適切に区別され，かつ他系統の悪性腫瘍（充実型低分化腺癌やびまん性大細胞型リンパ腫など）は確実に除外されなければならない．これらの病理学的な鑑別診断にはマクロとミクロの形態学的検索の他，免疫組織化学染色を用いた発現形質の検索や臨床情報の収集も必要となる．

　Gastric endocrine neoplasms are roughly classified into two histologic types：carcinoid tumours and endocrine cell carcinomas. Both the histologic types are classified as malignant epithelial neoplasms, but the tumourigenesis and clinicopathological features differ considerably. Therefore, both the histologic types must pathologically and properly distinguished, and other types of malignant neoplasm（e.g., solid-type poorly differentiated adenocarcinoma and diffuse large cell lymphoma）must be reliably excluded. For differential diagnosis, phenotypic expression must be evaluated by immunohistochemical staining and clinical information must be collected.