食道上皮下病変の超音波内視鏡診断

Diagnosis of Esophageal Lesions with Subepithelial Growth Using Endoscopic Ultrasound

要旨●EGDにおいて，食道にしばしば上皮下病変を認めることがあるが，ほとんどが平滑筋腫などのいわゆる粘膜下腫瘍である．しかし，それ以外にも非腫瘍性の壁外性圧排や静脈瘤，上皮性腫瘍である扁平上皮癌や特殊型食道癌など上皮下腫瘍様隆起を呈する病変が発生しうる．まれな症例においてはEUS像の典型像に関してまだわからないことも多いが，典型的な病変も多く，内視鏡像と合わせてEUSを用いて確実に診断していくことが重要であると考える．

　EGD（esophagogastroduodenoscopy）often reveals subepithelial lesions in the esophagus, most of which are submucosal tumors, such as leiomyomas. However, other lesions with subepithelial tumor-like elevations can also be present. These include nonneoplastic lesions, such as those causing extramural compression or esophageal varices, and epithelial tumors, such as squamous cell carcinoma and certain types of esophageal carcinomas. Although the value of EUS（endoscopic ultrasound）imaging of rare tumors is still unknown, clinicians must use EUS in conjunction with EGD imaging for precise diagnosis of typical lesions.