胃と腸47巻8号

2012年07月発行

今月の主題 胃ポリープの意義と鑑別

主題症例

プロトンポンプ阻害薬長期服用中に発生した胃底腺ポリープ内にdysplasiaを認めた1例

著者： 青井健司¹ 安永祐一¹ 松浦倫子¹ 池添世里子¹ 森田香織¹ 増田江利子¹ 柳川和範¹ 福島寿一¹ 乾由明¹ 興梠隆² 岡一雅² 河田純男¹

所属機関： ¹兵庫県立西宮病院消化器内科 ²兵庫県立西宮病院病理

ページ範囲：P.1270 - P.1274

文献概要

要旨　45歳，男性．非びらん性胃食道逆流症に対しランソプラゾール30mg内服15か月後，5mmの胃底腺ポリープ（FGP）を認め，さらに2年後10mmと増大，生検で表層にdysplasiaを認め，内視鏡的粘膜切除術を施行した．病理検査でdysplasia部はKi-67（＋）細胞が増加，p53（＋）細胞が散見，β-cateninは細胞膜のみ染色され，MUC5AC（＋）細胞が主となりMUC6（＋），MUC2（－），CD10（－）で胃腺窩上皮型の形質を示した．大腸ポリープを認めず，家族歴もないため，家族性大腸腺腫症は否定的であった．プロトンポンプ阻害薬関連FGP内にdysplasiaを認める症例が存在することを示した．

参考文献

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