胃Xanthomaの背景粘膜に関する検討(第1報)

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  • CLINICAL STUDY ON BACKGROUND MUCOSA OF GASTRIC XANTHOMA (PRELNMINAR REPORT)

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Endoscopic study on background mucosa of gastric xanthoma was carried out in 51 cases. For evaluating a relationship between glandular border and location of gastric xanthoma, endoscopic Congo-red Test was performed in 31 cases. No relationship between glandular border and location was proved, and the majority were found in the pyloric gland area. However, 4 cases were situated in darkly colored area by Congo-red Test, which was proved to be fundic mucosa by biopsy and 5 were located in the intermediate zone. Simultaneous study of atrophic grade shows slight to moderate atrophy in the majority. No significant difference was shown in severity of atrophy between the mucosa of 2 cm oral and anal side of xanthoma surface. With Methylene Blue Dyeing Method, xanthoma surface stained positively in only one of 14. The adjacent area did not stain, but the mucosa over 2cm away from xanthoma tended to stain positively in the majority. Biopsy specimens obtained simultaneously demonstrated similar tendency ; intestinal metaplasia on xanthoma surface was negative in 51.6%, when it exists, it was slight (38.7&) and the surrounding mucosa showed intestinal metaplasia more frequently than xanthoma surface. Although, the present study showed gastric atrophy to be a related factor of xanthoma pathogenesis, the possibility of existance of gastric xanthoma without accompanyng gastric mucosal atrophy was suggested. At the same thme, the role of intestinal metaplasia in xanthoma was not clarified in the present, and more detailed investigation will be required in the future for explaining the relationship with intestinal metaplasia.

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