| 特集名 | 消化管粘膜下腫瘍（SMT）の診療 | |
|---|---|---|
| 題名 | 食道でみられる粘膜下腫瘍 | |
| 発刊年月 | 2018年 11月 | |
| 著者 | 島田 英雄 | 東海大学大磯病院外科 |
| 著者 | 西 隆之 | 東海大学大磯病院外科 |
| 著者 | 冨田 さくら | 東海大学大磯病院病理診断科 |
| 著者 | 千野 修 | 東海大学東京病院外科 |
| 著者 | 小澤 壯治 | 東海大学医学部消化器外科 |
| 著者 | 幕内 博康 | 東海大学八王子病院外科 |
| 【 要旨 】 | 食道粘膜下腫瘍（SMT）の多くは良性腫瘍で隆起型である．自覚症状を認めるものは少なく，内視鏡検査で発見されることが多い．一般的に小さな食道SMTでは，経過観察される症例も多いがコンセンサスはない．内視鏡所見での特徴的な形態や色調から鑑別診断が容易な症例もある．食道SMTのなかでもっとも頻度の高いのは平滑筋腫である．しかし，内視鏡所見から平滑筋腫ときわめてまれでかつ悪性の可能性を有する食道GISTの鑑別は難しい．生検診断が必要でGISTと診断されれば外科手術の適応となる．また上皮性腫瘍でも，SMT様の形態を呈するものがある．その多くは悪性腫瘍であり，確定診断後には各疾患に応じた治療が選択される． | |
| Theme | Managements of Submucosal Tumors (SMT) in the Gastrointestinal Tract | |
|---|---|---|
| Title | Submucosal Tumors Observed in the Esophagus | |
| Author | Hideo Shimada | Department of Surgery, Tokai University Oiso Hospital |
| Author | Takayuki Nishi | Department of Surgery, Tokai University Oiso Hospital |
| Author | Sakura Tomoita | Department of Pathology, Tokai University Oiso Hospital |
| Author | Osamu Chino | Department of Surgery, Tokai University Tokyo Hospital |
| Author | Soji Ozawa | Department of Surgery, Tokai University School of Medicine |
| Author | Hiroyasu Makuuchi | Department of Surgery, Tokai University Hachioji Hospital |
| [ Summary ] | Most esophageal submucosal tumors (SMTs) are benign and of the protruding type. There are few cases that recognize subjective symptoms and there are often found by endoscopic examinations. In general, small esophageal SMT has many progress observation cases, but there is no consensus. In some cases, differential diagnosis is easy owing to characteristic morphology and color tone in endoscopic findings. The most frequently occurring type of esophageal SMT is leiomyoma. However, it is difficult to distinguish between leiomyoma and esophageal gastrointestinal stromal tumors (GISTs) with the possibility of malignancy from endoscopic findings. Therefore, biopsy is absolutely necessary for definite diagnosis. If the tumor is diagnosed as GIST, the patient is indicated for surgery. Epithelial tumors also have some submucosal tumor-like morphological characteristics. Many of them are malignant tumors and definitive diagnosis is followed by treatment according to each disease. |
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