cap polyposisと粘膜脱症候群はどう違うのか―病理の立場から

The Difference between Cap Polyposis and Mucosal Prolapse Syndrome: from the Pathological Standpoint of View

要旨　cap polyposis（CP）と粘膜脱症候群（MPS）の概念，形態学的特徴および病因について文献的に概説した．その後両者の異同を知る目的で，CP 3例，MPS 21例を用いて，病理組織学的立場から両者を比較検討した．MPSの線維筋症と毛細血管の増生，拡張は中等度以上のものが多いのに対し，CPのそれらは軽度のものが多かった．そして，MPSの線維筋症は通常平滑筋細胞と線維成分から構成され，しばしば粘膜中層から表層まで進展していた．これに対しCPのそれは細い平滑筋線維束から成り，粘膜深層に存在し，粘膜中層以上に進展してくることはほとんどなかった．一方，肉芽組織形成と炎症細胞浸潤はMPSよりCPで強い傾向があった．以上の結果から，両疾患はお互い独立した疾患単位として区別するのが妥当と結論した．

　The concept, morphologic characteristics and pathogenesis of cap polyposis (CP) and mucosal prolapse syndrome (MPS) was briefly described according to the literature. In addition, in order to know the similarities and differences of the two disorders, three cases of CP and 21 cases of MPS were studied comparatively from the histopathological standpoint. The degree of proliferation and dilatation of capillaries was moderate or severe in MPS, whereas, in CP, it was mostly mild. Fibromusculosis in MPS is usually composed of smooth muscle cells and fibrous components and it often extends from the middle to the superficial portion of the mucosa from a thickened muscularis mucosae. In contrast to this, fibromusculosis in CP is composed of thin bundles of smooth muscle fibers, and it is recognized in the deepest portion of the mucosa and seldom extends beyond the middle layer. On the other hand, there was a tendency for the degree of granulation-tissue formation and inflammatory cell infiltration to be higher in cases of CP than in those of MPS. From those results it was concluded that the two disorders are independent clinical entities and should be recognized as such.