胃粘膜下腫瘍の通常内視鏡・超音波内視鏡診断

Diagnosis for Gastric Submucosal Tumors

要旨●胃粘膜下腫瘍は上部消化管内視鏡検査において偶然発見されることが多く，その内容は平滑筋腫やGISTなどの間葉系腫瘍から脂肪腫，囊胞性病変まで多岐にわたる．粘膜下腫瘍様の隆起を発見した際には，まず壁外性の圧迫によるものを除外した後に，形状や部位，大きさ，色調，陥凹や潰瘍形成の有無，硬さ，単発/多発性について観察する．通常内視鏡観察である程度の鑑別を行った後にEUSを行う．EUSでは腫瘍の主座やエコーレベル，エコーパターンに留意して観察を行う．

　Gastric submucosal tumors are found by chance during upper gastrointestinal endoscopy, and their contents range from mesenchymal tumors, such as leiomyoma and GIST, to lipomas and cystic lesions. When submucosal tumor-like protuberances are discovered, first exclude those caused by external wall pressure. Second, observe the shape, part, size, color tone, presence or absence of recession or ulceration, hardness, and single/multiple occurrence. Usually, EUS is performed after a certain degree of discrimination by endoscopic observation. During EUS, observe the main locus of the tumor, echo level, and echo pattern.