転移性胃腫瘍の画像診断・形態学的特徴—乳癌胃転移を中心に

Morphologic Diagnosis of Metastatic Gastric Tumors and Metastatic Gastric Tumor from Breast Cancer:A Systematic Review:

要旨●転移性胃腫瘍は他臓器の原発腫瘍が，胃に転移した病変の総称である．本稿では，転移性胃腫瘍について既報における剖検例，および自験例における内視鏡所見と病理組織学的所見を検討した．また，乳癌の転移性胃癌についてシステマチックレビューを行った．乳癌の胃転移は，肉眼型は4型進行癌様を54.1%で呈し，U・M・L領域のどの部位にもみられ（U領域38.0%，M領域31.3%，L領域46.4%），内視鏡的，病理組織学的にも原発性胃癌と類似する病変が多かった．転移性胃腫瘍は全体的にU・M領域を好発部位とし，粘膜下腫瘍様形態を呈することが多く，乳癌の胃転移は転移性胃癌の中でも他の癌腫と異なる特徴を持つことが示唆された．

　Metastatic gastric tumors indicate lesions from extragastric tumors that metastasize to the stomach. In this study, endoscopic and clinicopathological features in metastatic gastric tumors of previous autopsy cases were reviewed. Furthermore, a systematic review was conducted for metastatic gastric tumors from breast cancer. Type 4 morphology was seen in 54.1% of cases, and metastatic tumors from breast cancer were present at various sites in the stomach（38.0% sites in the U region, 31.3% in the M region, and 46.4% in the L region）. These lesions showed both endoscopic and pathological similarity with primary gastric cancer. U and M regions were frequent sites of metastasis, and submucosal tumor type was the most common morphology in metastatic gastric tumors. Metastatic tumors from breast cancer indicate that they have different characteristics than other metastatic gastric tumors.