내시경 점막하 박리술로 치료한 위의 염증성 섬유양 용종
Gastric Inflammatory Fibroid Polyp Resected by Endoscopic Submucosal Dissection
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초록
염증성 섬유양 용종은 위장관의 점막하층에 발생하는 드문 양성 섬유증식성 질환이다. 내시경 및 내시경 초음파에서 특징적인 소견이 없어 대부분 완전절제 후 병리학적으로 진단된다. 치료는 주로 외과적 수술이 시행되고 있으며, 최근에는 내시경 절제술로 진단되는 경우가 증가하고 있으나 아직 크기가 작거나 유경성인 경우에만 제한적으로 이루어지고 있다. 최근 도입된 내시경 점막하 박리술은 크기 및 위치와 상관없이 일괄절제를 가능하게 하는 장점이 있어, 본 질환과 같이 내시경을 통한 조직검사나 내시경 초음파만으로 절제 전 양성과 악성의 감별이 어려운 경우에 있어 불필요한 외과 치료를 피하고 내시경으로 제거하는데 유용할 것으로 생각한다. 저자들은 위의 점막하 종양을 주소로 전원된 45세 여자에서 내시경 조직검사 및 내시경 초음파를 시행하였으나 진단되지 않아 내시경 점막하 박리술을 시행한 후 염증성 섬유양 용종으로 진단한 1예를 경험하여 이에 대한 이해를 넓히고자 문헌고찰과 함께 보고한다.
Abstract
Inflammatory fibroid polyp (IFP) is a rare benign fibroproliferative disease that arises from the submucosal layer of the gastrointestinal tract. Surgical resection has been performed in most cases and the application of endoscopic resection is rare. Endoscopic submucosal dissection (ESD), which was recently introduced, enables en-bloc resection of a tumor regardless of the tumor size and location. Since IFP is benign, ESD can be very useful for both the diagnosis and treatment of a large-sized IFP. A 45-year-old woman was referred for the management of a gastric mass. Esophagogastroduodenoscopy showed a round submucosal mass with a central bulging at the gastric body. Endoscopic ultrasonography showed a 3.5×3.0 cm-sized hypoechoic mass in the third layer of the stomach. The tumor was removed by ESD with using a hook knife for complete en-bloc resection. The pathologic finding was compatible with the diagnosis of IFP. We report here on a case of IFP that presented as a gastric submucosal tumor and it was treated by the ESD method.
참고문헌 (17)
- Helwig EB, "Inflammatory fibroid polyps of the stomach", Surg Gynecol Obstet, 96, pp.335~3674 (1953)
- Vanek J, "Gastric submucosal granuloma with eosinophilic infiltration", Am J Pathol, 25, pp.397~411 (1949)
- Cho NH, "A pathological and immunohistochemical study of 9 cases of inflammatory fibroid polyp", Korean J Pathol, 23, pp.20~28 (1989)
- Tada S, "Endoscopic removal of inflammatory fibroid polyps of the stomach", Am J Gastroenterol, 86, pp.1247~1250 (1991)
- Yasda K, "Endoscopic ultrasonography in the diagnosis of submucosal tumor of the upper digestive tract", Scand J Gastroenterol, 123, pp.59S~67S (1986)
- Song Dh, "4 cases of inflammatory fibroid polyp of the stomach: the findings of endoscopic ultrasonography", Korean J Gastrointest Endosc, 13, pp.353~362 (1993)
- Hizawa K, "Endoscopic evaluation of gastric inflammatory fibroid polyp", Surg Endosc, 9, pp.397~400 (1995)
- 김기환, "위암 양상을 보인 염증성 섬유양 용종", 대한외과학회지, 65(01), pp.13~13 (2003), 대한외과학회
- Kim YI, "Inflammatory fibroid polyps of the gastrointestinal tract. in: Evolution of histologic patterns", Am J Clin Pathol, 89, pp.721~727 (1988)
- Buciuto R, "Helicobacter pylori gastritis associated with a gastric inflammatory fibroid tumour and sarcoidosis", Eur J Surg, 162, pp.421~424 (1996)
- Nishiyama Y, "Gastric inflammatory fibroid polyp treated with Helicobacter pylori eradication therapy", Intern Med, 42, pp.263~267 (2003)
- Samter TG, "Inflammatory fibroid polyps of the gastrointestinal tract. in: A report of 3 cases, 2 occurring in children", Am J Clin Pathol, 45, pp.420~436 (1996)
- Daum O, "Vanek's tumor (inflammatory fibroid polyp). Report of 18 cases and comparison with three cases of original Vanek's series", Ann Diagn Pathol, 7, pp.337~347 (2003)
- Makhlouf HR, "Inflammatory myofibroblastic tumors (inflammatory pseudotumors) of the gastrointestinal tract: how closely are they related to inflammatory fibroid polyps?", Hum Pathol, 33, pp.307~315 (2002)
- Mori M, "Concomitant presence of inflammatory fibroid polyp and carcinoma or adenoma in the stomach", Arch Pathol Lab Med, 112, pp.829~832 (1988)
- Sauter KE, "Intermittent pyloric obstruction due to prolapse of an inflammatory fibroid polyp of the stomach", Wis Med J, 61, pp.175~180 (1962)
- Zinkiewicz K, "Recurrent inflammatory fibroid polyp of cardia: a case report", World J Gastroenterol, 10, pp.767~768 (2004)