腸型Behçet病と腸simple ulcerの病理形態像の推移

Pathomorphological Change of Intestinal Behçet's Disease and Simple Ulcer

要旨　腸型Behçet病/腸simple ulcer 24例の外科切除腸材料を用いて，腸潰瘍の形態学的推移を検討した．対象潰瘍数は202個（Ul-Ⅰ 4，Ul-Ⅱ 64，Ul-Ⅲ 66，Ul-Ⅳ 68）で，急性型21個，慢性活動型122個，治癒59個であった．慢性活動型潰瘍には，急性型から移行するものと最初からその型のものとがあると推測された．Ul-Ⅳの慢性活動型潰瘍は浅い同型潰瘍が進行した場合と，Ul-Ⅳ急性型潰瘍に由来するものとがあると考えられた．慢性活動型潰瘍の進行・難治化にはリンパ球・形質細胞浸潤が主役をなし，これは消化性胃潰瘍のそれに酸が大きく関与するのとは，組織像を異にしていた．

　Twenty-four surgical cases with intestinal Behçet's disease and/or simple ulcer were examined in order to study morphological change of the intestinal ulcers with medical therapy and time. All the ulcers examined histologically were 202, and their depth were Ul-Ⅰ in 4, Ul-Ⅱ in 64, Ul-Ⅲ in 66 and Ul-Ⅳ in 68 ulcers, The phases of the 202 ulcers were devided into three types; acute type in 21, chronic active type in 122 and healed type in 59 ulcers. Two pathways of the development of chronic active ulcer are supposed; one is chronic transformation from acute ulcer and the other is ab initio chronic active ulcer. Chronic active Ul-Ⅳ ulcer is supposed to develop from shallow chronic active ulcers on many occasions and from acute Ul-Ⅳ ulcers on some occasions. Deepening and incurability of chronic active ulcer is due to persistence of chronic inflammatory cell infiltration mainly composed of lymphocytes and plasma cells on the ulcer base. It is completely different from histological findings of gastric peptic ulcer largely related to gastric acid.