食道上皮下病変のEUS-FNA診断

Endoscopic Ultrasound Fine-needle Aspiration for Gastrointestinal Subepithelial Lesions

要旨●消化管上皮下病変（gastrointestinal subepithelial lesions ; GISELs）は上下部内視鏡検査において，偶発的に発見されることも多く，日常診療においてしばしば遭遇する．病変の主座が上皮下に存在し，表面は正常上皮で覆われているため，通常観察のみでの画像診断は困難であり，通常の内視鏡下鉗子生検では病理組織学的診断も困難な場合が多い．EUS-FNAは，GISELsに対して安全かつ正確に病理組織学的診断ができる有用な検査法であり，本稿では食道上皮下病変に対するEUS-FNAについて解説する．

　GISELs（gastrointestinal subepithelial lesions）are frequently incidentally detected during upper and lower gastrointestinal endoscopic examinations and are predominantly encountered in clinical practice. The primary site of these lesions is under the epithelium ; diagnosis using various imaging techniques is arduous because the surface is covered with normal epithelium. Furthermore, obtaining a pathological diagnosis through standard endoscopic forceps biopsy is frequently challenging. EUS-FNA（endoscopic ultrasound fine-needle aspiration）is an essential technique that enables safe and accurate pathological diagnosis of GISELs. This article provides an overview of EUS-FNA for subepithelial esophageal lesions.