消化管のまれな粘膜下腫瘍および粘膜下腫瘍様病変の診断

Diagnosis of Rare Cases of Gastrointestinal Submucosal Tumors and Submucosal Tumor-like Lesions

要旨　消化管の粘膜下層に主座がある病変には，腫瘍の他に種々の病変がある．それらの病変の中には，形態上で粘膜下腫瘍に類似した所見を示すので，日常の診断の場で粘膜下腫瘍との鑑別が必要となるものがある．そこで今回，症例の呈示とともに，異所性粘膜，壁の石灰化病変，壁内血腫，静脈瘤，pyogenic granuloma，リンパ節転移，消化管壁への転移性腫瘍，腸管子宮内膜症，大腸深在性嚢胞症，管外性腫瘤からの圧迫・圧排，浸潤した病変などについて，その特徴像を述べた．

　We have observed many kinds of lesions in the gastrointestinal submucosa other than the original gastrointestinal tumors. However, as these lesions are frequently similar to gastrointestinal submucosal tumors, it is necessary to distinguish clearly between the submucosal tumors and other types of lesion. Masses in the submucosa were identified as ectopic mucosa, calcification or hematoma in the vessels, varices, pyogenic granuloma, metastatic carcinoma in the lymph nodes and the walls of the gastrointestinal tract, intestinal endometriosis, colitis cystica profunda, and extra-gastrointestinal tract tumors. Here, we describe these cases and their manifestations of invasion or compression by lesions.

　1) National Kyushu Cancer Center, Fukuoka, Japan