胃粗大皺襞症について

ON THE GIANT RUGAE OF THE STOMACH

Ⅰ．はじめに

　最近胃癌に関する知識の普及とともに，自覚的，他覚的に胃癌を疑って診察を受ける患者が多く来院するようになった．このような患者のうち異常を発見されて，胃切除を施行されたもののなかには，癌腫や潰瘍を伴なわずに胃粘膜搬奨の増加と肥厚を特徴とする症例が少数ながら見出される．これはいわゆるgiant rugae¹⁾または，胃粗大皺襞症²⁾とよばれるものであって，臨床上癌腫との鑑別が問題となり，その本態や病理についても議論の多い疾患である．昭和40年2月消化器病センター開設から昭和42年8月まで2年半にこのような9症例を経験した．今回は肉眼ならびに病理組織所見について検討を試みたので報告する．

　During the two and a half years since the establishment of The Institute of Gastroenterology in February 1965 to August 1967, we have encountered the total of 9 cases of the giant rugae of the stomach, which by definition are the enlargement and the thickening of mucosal folds of the stomach without either cancerous or ulcerous tendencies.

　Through macroscopical observation on the pathological viewpoint, the giant rugae of the stomach were further classified into two types: the localized thickening, and the diffuse thickening, of the mucosal folds.

　Pathohistologically the giant rugosity seems to concur with the dynamic mucosal changes observed in the chronic type of nonspecific gastritis, in which it is possible to find successive steps from hyperplastic reactionary inflammatory processes in the earlier stage through hyperplastic-atrophic processes in the subsequent one to atrophy in the terminal stage. And thus we came to the conclusion that the giant rugae of the stomach fall within the category of chronic gastritis, though with varying degree of severity in tissue reaction.