白色化・白色絨毛を伴う十二指腸病変の拡大内視鏡所見

Magnified Endoscopic Findings of Duodenal Lesions with Whitening and White Villi

要旨●十二指腸の白色化，白色絨毛を呈する疾患として，上皮性腫瘍，濾胞性リンパ腫，リンパ管腫，ランタン沈着，Whipple病，アミロイドーシス，健常者食事摂取後の白色絨毛と撒布性白点（白斑）を取り上げ，自験例と過去の報告に基づき，各病変の白く見える成分とその存在部位について，拡大内視鏡所見と病理組織学的所見を照らし合わせて検討した．十二指腸白色病変の拡大観察において，白色領域の絨毛構造内での分布と血管透見像の評価により，白色成分のある程度の推測が可能で，疾患の診断にも有用と考えられた．

　Based on personal experiences and previous reports, we discussed the following diseases that are characterized by the whitening of the duodenum and white villi：epithelial tumors, follicular lymphomas, lymphangioma, lanthanum deposition, Whipple's disease, amyloidosis, white villi and white spots after ingestion of healthy subjects. The white component of each lesion and its location were examined by comparing the magnified endoscopic findings with the lesions' histopathology. In the magnified duodenal white lesions, the distribution of white areas within the villous structure and the evaluation of the vascular translucency images enabled us to identify and understand the white component to some extent, which might be beneficial in the diagnosis of the disease.