胃と腸44巻4号

2009年04月発行

特集 早期胃癌2009

主題 7．特殊な成り立ちの早期胃癌

1）Epstein-Barr virus関連胃癌

著者： 牛久哲男¹ 篠崎綾¹ 深山正久¹

所属機関： ¹東京大学医学部附属病院病理部

ページ範囲：P.723 - P.729

文献概要

要旨　EBV関連胃癌はEBVに感染した上皮細胞がモノクローナルに増殖した腫瘍で，胃癌全体の約10％を占め，際立った臨床病理学的特徴を有する．一般の胃癌に比べ男性に多く，やや若年に発生する傾向があり，胃の近位側に好発する．内視鏡像では0 IIc型主体の例が多い．組織型はtub2（66％）ないしpor1（21％）と診断されることが多いが，特異的な組織パターンとしてlace patternとリンパ球浸潤癌が知られている．前者は粘膜内でみられることが多く，後者は粘膜下層浸潤部で認められ，結節状増殖を示す．粘液形質は特徴的に無形質か胃型形質を示す．予後良好な傾向があり，早期癌でのリンパ節転移はまれである．

参考文献

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