과형성 위용종에서 발생한 위선암 2예
Two Cases of Adenocarcinoma Arising from Gastric Hyperplastic Polyp
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초록
위용종은 위에 발생하는 흔한 양성 신생물로서 크게 과형성 용종과 선종성 용종으로 나누고 과형성 용종이 가장 흔하며 전체의 75~90%를 차지한다. 선종성 용종은 부분적 선암을 동반한 경우가 6~75%로 다양하게 보고되고 있으며, 과형성 용종은 1.5~2.1%로 낮은 것으로 알려져 있다. 따라서 선종성 용종은 전암성 병변으로 인식되어 용종 절제술의 일반적인 적응증이었으나, 과형성 용종은 자연경과 및 용종절제술의 적응 유무에 대해 아직 정립된 바가 없다. 저자들은 위 내시경 검사에서 발견한 조기위암을 수술적 치료 후 조직검사에서 중등도 분화 선암이 일부 있는 과형성 용종 1예와, 내시경 치료 후 조직검사에서 고분화 선암이 일부 있는 과형성 용종 1예를 경험하고 문헌고찰과 함께 보고한다.
Abstract
Epithelial gastric polyps can be categorized as being either hyperplastic or adenomatous. Hyperplastic polyps accounts for 75∼90% of gastric polyps. In contrast to the adenomatous polyps, the potential of a malignant transformation of hyperplastic polyps was originally believed to be quite low (an incidence of 1.5∼2.1%), which is considerably lower than that of an adenoma of the stomach. Most of reported cases of a hyperplastic gastric polyp with a transformation to adenocarcinoma were well differentiated histopathologically. There are few reports of a hyperplastic polyp in which malignant changes developed during the endoscopic surveillance. We report a rare case of a 1.2 cm sized moderately differentiated adenocarcinoma arising in a hyperplastic polyp on the cardia in the stomach with a brief review of the relevant literature.
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