臨牀消化器内科 Vol.14 No.11(2-6)


特集名 虫垂疾患とその周辺
題名 虫垂疾患の各論 (6) その他のまれな虫垂疾患
発刊年月 1999年 10月
著者 山本 哲久 防衛医科大学校外科学第一講座
【 要旨 】 虫垂腺癌の頻度は0.08%で,粘液嚢胞腺癌のO.5%よりも低く,回盲部が一塊となった腫瘤で診断される.予後不良.虫垂悪性リンパ腫は,本邦で20例報告.病理診断,病期分類ともに未だcontroversialで,新しい免疫学的・分子生物学的知見による治療法の確立が望まれる.転移性虫垂癌は,本邦で24例報告.胃癌原発が多く,穿孔を起こしやすい.胃全摘術後の急性虫垂炎症状は,虫垂転移も念頭に治療に当たる必要がある.虫垂重積症の頻度はO.01%で,慢性虫垂炎症状か無症状が多い.腫瘍性病変を否定できない例は手術適応.虫垂子宮内膜症は,月経周期と必ずしも一致しない虫垂炎様症状を呈する.虫垂結石の頻度は0.7%で,虫垂炎の成因,進展に密接な関与が指摘されている.
Theme Disease of Appendix and its Allied Condition
Title Rare Diseases of Appendix
Author Tetsuhisa Yamamoto Department of Surgery I, National Defense Medical College
[ Summary ] Rare diseases of the appendix are reviewed. The incidence of primary adenocarcinoma is 0.O8%. Diagnosis is difficult until the tumor grows large enough. The strategies for treatment of primary malignant lymphoma are still controversial. A new immunopathological sorting system or new staging procedures are being investigated. The origin of appendiceal metastatic cancer is most likely the stomach. Perforation of the metastatic lesion occurs frequently. Intussusception of the appendix upon itself is surgically treated when the presence of a neoplasm cannot be excluded. Symptoms of endometriosis are similar to those of acute appendicitis, and not necessarily in accordance with menstruatural periods. Appendiceal calculi are closely related to the pathogenesis and development of appendicitis.
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