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要旨●大腸には,頻度は低いものの,脂肪腫,平滑筋腫,種々の神経原性腫瘍,GIST,脈管系腫瘍,悪性黒色腫など,多彩な非上皮性腫瘍が発生し,さまざまな形態のポリープ病変を形成する.非上皮性腫瘍の多くは病変の主座を粘膜下に置くが,腫瘍組織の状況によって粘膜面に形成される隆起性病変の形態が修飾される.また,腫瘍によっては種々の程度に粘膜固有層に進展し,粘膜の組織構築に影響する.これらの点を認識しておくこと,それぞれの病変がどのような病理組織学的所見から成り立っているのかを十分に理解しておくことは,病変の部分像のみをみることになる生検病理組織学的診断を含めて,さまざまな非上皮性腫瘍による大腸ポリープ病変を正しく診断するために必須のことと考えられる.
Various nonepithelial neoplasms arise from the colorectum, including lipoma, leiomyoma, various neurogenic neoplasms, GIST(gastrointestinal stromal tumor), vascular neoplasms, and melanoma, although the frequency is low compared with that of epithelial neoplasms. These neoplasms are frequently found as polypoid lesions, which are variable in morphology. Most of these neoplasms primarily grow in the submucosa and deeper part of the intestinal wall, and modify the morphology of the mucosal surface. Moreover, certain neoplasms grow in the lamina propria mucosa, thereby affecting the histologic structure of the mucosa. Recognizing these aspects and understanding the pathological findings underlying the morphology of each neoplasm are essential for the accurate diagnosis of colorectal nonepithelial neoplastic polyps, including the histopathologic diagnosis of biopsy materials, which usually reflect as a part of the neoplasm.
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