| 特集名 | Villous Tumor | |
|---|---|---|
| 題名 | 臨床の立場から (1) villous tumorの内視鏡診断 g. serrated adenomaとの異同について | |
| 発刊年月 | 2001年 01月 | |
| 著者 | 斎藤 豊 | 国立がんセンター中央病院内視鏡部 |
| 著者 | 目良 清美 | 国立がんセンター東病院内視鏡部 |
| 著者 | 藤井 隆広 | 国立がんセンター中央病院内視鏡部 |
| 著者 | 神津 隆弘 | 国立がんセンター中央病院内視鏡部 |
| 著者 | 佐野 寧 | 国立がんセンター東病院内視鏡部 |
| 著者 | 加藤 茂治 | 加藤胃腸科クリニック |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Villous Tumor | |
|---|---|---|
| Title | Endoscopic diagnosis of villous tumors of colon and rectum with special reference to comparisons with serrated adenoma | |
| Author | Yutaka Saito | Department of Gastrointestinal Endoscopy, National Cancer Center Hospital |
| Author | Kiyomi Mera | Department of Gastrointestinal Endoscopy, National Cancer Center Hospital East |
| Author | Takahiro Fujii | Department of Gastrointestinal Endoscopy, National Cancer Center Hospital |
| Author | Takahiro Kozu | Department of Gastrointestinal Endoscopy, National Cancer Center Hospital |
| Author | Yasushi Sano | Department of Gastrointestinal Endoscopy, National Cancer Center Hospital East |
| Author | Shigeharu Kato | Kato Clinic |
| [ Summary ] | Villous and papillary patterns, seen both macroscopically and microscopically, are the most characteristic findings of villous tumors (VT). Recently, the concept of a serrated adenoma (SA) has been proposed. The differential diagnosis between SA and VT is sometimes difficult because both show a papillary growth pattern. The purpose of this study is to evaluate the endoscopic features of VT, compared to SA. We classified SA in two types, based on their magnified endoscopic features. The first being the serrated hyper type (SH), in which the surface structure reveals IIIH type pits, similar to hyperplastic polyps, with a fern-like appearance, and the second being the serrated villous type (SV), which displays an IVH type pit pattern, similar to VT, with a pine cone-like appearance. The pine cone-like appearance probably reflects an edematous change of the stroma, as seen histologically. Moreover, a magnifying view demonstrates this fern-like appearance, which histologically reflects a serrated change. On the other hand, VT reveals a type IV pit pattern, without a pine cone-like appearance, which, probably, suggests a thin stroma histologically. However, a magnifying view does not demonstrate a fern-like appearance. Furthermore, both SA and VT were predominantly located in the sigmoid colon and the rectum. The rate of serrated components decreased as the depth of tumors increased and the size of the tumor was larger in those which displayed a villous pattern. Considering these facts, we suggest a hyperplastic polyp-SA-VT sequence, as sociated with tumor growth and development. Further studies are necessary to establish the nature of this sequence. |
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