小腸クローン病の肉眼所見，特に小潰瘍性病変について―全割切片作製による再構築から

Macroscopic Appearance of Crohn's Disease of the Small Intestine Based on Wholly Sectioned Specimens: Special reference to small ulcerative lesions

　近年，腸X線検査法の進歩に伴って，本邦においては少ないとされていたクローン病の報告例²⁾⁸⁾⁹⁾が増加している．最近，日本消化器病学会においてクローン病の診断基準に関するひとつの案が提示されている．また，1977年10月には第19回日本消化器病学会秋季大会でシンポジウム「クローン病と類縁疾患」がとりあげられ，本症の臨床的，病理学的検討が行われた．

　一方，わが国では腸結核はかなり減少したといわれているが，それでもなおかなりの報告例⁶⁾¹⁰⁾がみられる．しかし，これらの中には乾酪壊死巣を伴わない肉芽腫だけを認める症例，あるいは肉眼的にクローン病に類似した所見を示す症例もあり，これら腸結核とクローン病との鑑別が問題となってきている．

　Histopathological investigations are made in seven patients which were histologically diagnosed as Crohn's disease from 1971 to 1977. For descriptive purposes, the lesions seen in specimens were divided into two regions; 1) longitudinal ulcers (and lesions associated with them) and 2) ulcers other than longitudinal ulcers.

　1) Longitudinal ulcers and lesions associated with them were divided ; the former into six types as in a) ～ f) (Fig. 13), the latter into eight types as in a) ～h) (Fig. 14).

　2) Ulcers other than longitudinal ulcers were divided into five types as in a) ～ e) (Fig. 15).

　3) As for the distribution of granuloma, granuloma was more frequently seen in types with longitudinal pathologies than in types with other pathologies.

　4) Extension to the proximal site of the pathology was histologically considered in six studied cases.