Endoscopical and Clinicopathological Study of Squamous Papilloma of Esophagus

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  • Kazuka Nozomi
    Department of Gastroenterology, Tokyo Women’s Medical University Aoyama Hospital Institute of Geriatrics, Tokyo Women's Medical University
  • Misaka Ryoichi
    Department of Gastroenterology, Tokyo Women’s Medical University Aoyama Hospital Institute of Geriatrics, Tokyo Women's Medical University
  • Yokoyama Naoko
    Department of Gastroenterology, Tokyo Women’s Medical University Aoyama Hospital Institute of Geriatrics, Tokyo Women's Medical University
  • Fuzita Mikiko
    Department of Gastroenterology, Tokyo Women’s Medical University Aoyama Hospital Institute of Geriatrics, Tokyo Women's Medical University
  • Omori Junko
    Department of Gastroenterology, Tokyo Women’s Medical University Aoyama Hospital Institute of Geriatrics, Tokyo Women's Medical University
  • Takeuchi Etsuko
    Department of Gastroenterology, Tokyo Women’s Medical University Aoyama Hospital Institute of Geriatrics, Tokyo Women's Medical University
  • Ishikawa Takayuki
    Department of Gastroenterology, Tokyo Women’s Medical University Aoyama Hospital Institute of Geriatrics, Tokyo Women's Medical University
  • Ogihara Shoji
    Department of Gastroenterology, Tokyo Women’s Medical University Aoyama Hospital Institute of Geriatrics, Tokyo Women's Medical University
  • Tsuchiya Mariko
    Department of Gastroenterology, Tokyo Women’s Medical University Aoyama Hospital Institute of Geriatrics, Tokyo Women's Medical University
  • Niimi Akiko
    Department of Gastroenterology, Tokyo Women’s Medical University Aoyama Hospital Institute of Geriatrics, Tokyo Women's Medical University
  • Maeda Atsushi
    Department of Gastroenterology, Tokyo Women’s Medical University Aoyama Hospital Institute of Geriatrics, Tokyo Women's Medical University
  • Shigemoto Mutsuo
    Department of Gastroenterology, Tokyo Women’s Medical University Aoyama Hospital Institute of Geriatrics, Tokyo Women's Medical University
  • Yamashita Katsuko
    Department of Gastroenterology, Tokyo Women’s Medical University Aoyama Hospital Institute of Geriatrics, Tokyo Women's Medical University
  • Imamura Tetsuo
    Department of Pathology, Teikyo University Hospital

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Other Title
  • 食道乳頭腫の内視鏡的および臨床病理学的検討

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Description

いわゆる食道乳頭腫は過形成性の扁平上皮が乳頭状増殖を示す腫瘍類似病変であり，真の腫瘍は稀とされている。近年その報告例は増加しており，自験例について内視鏡的および病理組織学的に検討し，食道乳頭腫の臨床的意義について再検討を試みた。過去4年間に当院にて食道乳頭腫23例，27病巣を経験した。性比は男 : 女＝12 : 11であり，平均年齢は50.3歳であった。単発例は21例，多発例は2例であった。病巣部位は中部食道15病巣（55.5％），下部食道9病巣（33.3％），SCJに3病巣（11.1％）を認め，中部食道に最も多かった。大きさは5mm未満のものが17病巣（59.2％）と半数以上を占めた。色調は白色調のものが多かった。肉眼形態について2型に分類すると，分葉型は6病巣（22.2％），非分葉型が21病巣（77.7％）と多かった。背景病変としては逆流性食道炎15病巣，食道裂孔ヘルニア14病巣，萎縮性胃炎7病巣であった。発生要因との関連で抗human papilloma virus（HPV）抗体を用いた免疫染色法にて4病巣に核濃染像を認めた。食道胃接合部および下部食道乳頭腫には逆流性食道炎の合併が多く，関連性が考えられた。臨床的には生検により診断を確定し内視鏡的切除を考慮すべきとする考えもあるが，基本的には良性腫瘍様病変であり，大きさや形態の変化に注意し定期的な経過観察で十分と考える。

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