画像所見と病理所見の対比法のコツ：大腸─真の対比は切除標本の取扱いにある

Method of Comparison between Imaging and Pathological Findings:Large Intestine

要旨●消化管における内視鏡診断の最終的な到達点は病理組織診断と一致することにある．内視鏡所見と病理組織像を対応させるには，①通常観察による病変全体の形態的特徴や拡大観察による表面微細構造，微細血管像の特徴を捉える．②一括切除あるいはそれに準じた形で切除を行う．③得られた標本を展翅し，ホルマリン固定を行う．④画像的特徴が反映されるように臨床医自ら，もしくは病理医へ内視鏡所見のスケッチなどを明示して標本を切り出し，プレパラートを作製する．ただし作製過程で削り落される部分のことも考慮して切り出す必要がある．地道な標本処理が診断学向上につながると考える．

　We think that the purpose of endoscopic diagnosis of the gastrointestinal tract is to ensure consistency in its findings with those of histopathological diagnosis. The correlation between endoscopic and histopathological findings depends upon the following conditions：1）understanding the entire lesion's gross morphological characteristic with normal endoscopic observations and its microsurface and microvascular structure with magnified observations, 2）en bloc or other appropriate resections, 3）maintaining specimen to be in vivo condition and fixing it in formaldehyde, and 4）slicing out of specimen by the clinician oneself or requesting pathologists with clear instructions so that image characteristics can be reflected. However, it is necessary for us to consider a part disappearing in a prepared slide manufacture process. We insist that such a steady manufacture process leads to diagnostics improvement.