粘膜下腫瘍様の形態を呈した食道表在癌の3例

Superficial Esophageal Carcinoma with Features of Submucosal Tumor, Report of Three Cases

要旨　粘膜下腫瘍様の食道表在癌3例を経験した．〔症例1〕は，内視鏡およびX線所見上，中心に比較的平滑な陥凹を有し，立ち上がりは健常粘膜で覆われた隆起性病変で，組織診断は低分化型扁平上皮癌，深達度sm3であった．〔症例2〕は，粘膜下からの立ち上がりを有し，くびれを伴う隆起性病変で，頂部は粗糙なびらん面を呈していた．組織診断は中分化型扁平上皮癌，sm3であった．〔症例3〕は，大部分が健常粘膜で覆われ，中心に深い陥凹を有する隆起性病変で，組織診断は中分化型扁平上皮癌，sm3であった．〔症例1，2〕では癌先進部を取り巻く線維化が認められ，〔症例3〕では著明なリンパ球浸潤が認められた．これらの間質反応が粘膜下腫瘍様の形態を示した一因と考えられた．

〔Case 1〕 Radiographic and endoscopic examination revealed an elevated lesion resembling a Submucosal tumor with a relatively smooth depression on its central surface on the lower thoracic esophagus. Histological diagnosis was a poorly differentiated squamous cell carcinoma. The depth of invasion was sm₃.

〔Case 2〕 Radiographic and endoscopic examination revealed a Submucosal tumor-like lesion with a smooth-surfaced bottom and rough erosion on its top surface on the lower thoracic esophagus. Histological diagnosis was a moderately differentiated squamous cell carcinoma. The depth of invasion was sm₃.

〔Case 3〕 Radiographic and endoscopic examination revealed an elevated lesion resembling a Submucosal tumor with a central deep depression, on the lower thoracic esophagus. Histological diagnosis was a moderately differentiated squamous cell carcinoma. The depth of invasion was sm₃. In 〔Case 1〕 and 〔Case 2〕, histological examination revealed well formed fibrosis on the invasive front of the tumor. In 〔Case 3〕, histological examination revealed well formed lymphocyte infiltration on the invasive front of the tumor. These intestinal reactions are suspected to be one of the factors which caused the features of Submucosal tumor.