胃腺腫およびIIa型早期胃癌の内視鏡的切除後に生じた過形成性ポリープの2例

Hyperplastic Polyp Developing after Endoscopic Resection of Gastric Adenoma or Early Gastric Cancer, Report of Two Cases

要旨　〔症例1〕は65歳，男性．内視鏡検査で胃幽門前庭部に直径1cmの褪色調山田II型ポリープを認め，内視鏡的に完全切除した．その病理診断は腺腫であった．切除6か月後の内視鏡検査で同部位に直径6mmの発赤調山田II型ポリープを認め，ポリペクトミーを施行し，過形成性ポリープであることが判明した．〔症例2〕は63歳，男性．内視鏡検査で胃幽門前庭部に直径1cmの褪色調扁平隆起を指摘された．粘膜切除術で完全切除した．病理組織は高分化腺癌(深達度m)であった．切除13か月後，同部位に直径7mmの発赤調山田II型ポリープを認め，ポリペクトミー後の病理組織検査では，過形成性ポリープであった．胃腺腫・早期胃癌の内視鏡的切除術後に生じたポリープの組織型について検討し，過形成性ポリープの2例を報告した．

　Case 1: Endoscapic examination of the upper gastrointestinal tract of a 65-year-old man showed a flat elevated lesion in the gastric antrum. The lesion was endoscopically tubular adenoma, and the histological examination also identified it as tubular adenoma. Follow-up endoscopy performed six month safter the resection found a reddish polypoid lesion in the resected site. The histological examination of the lesion removed by endoscopic mucosectomy identified it as a hyperplastic polyp.

　Case 2: A 63-year-old man was admitted for preventive endoscopic sclerotherapy of esophageal varices. Endoscopic examination of the upper gastrointestinal tract showed a flat elevated lesion in the gastric antrum. The lesion removed by endoscopic mucosectomy was revealed histologically as well differentiated adenocarcinoma in the ucosa. Follow-up endoscopy about one year after the mucosectomy identified a reddish polypoid lesion in the resected site, which was identified histologically as hyperplastic polyp.

　We have reported these two cases of hyperplastic polyp developing after endoscopic resection of gastric neoplasm.