食道胃移行部粘膜とすい様胞状腺 手術材料における組織標本の検索を中心に

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  • Pancreas like acinar glands in the esophagogastric junctional mucosa.

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Esophagogastric material resected for malignancy, obtained from 52 adult patients, was examined histologically. In a longitudinal examination of 32 total gastrectomies, intramucosally located pancreatic acinar cell-like cells (PALC) were observed frequently (10 of 12 patients, p<0.05) only in the uppermost one-sixth part, especially in a 10 mm-long zone around the squamocolumnar junction (SCJ). Entire sampling of the junctional mucosa revealed no significant difference in frequency of occurrence of PALC between esophageal and gastric cancer groups (13 of 20 patients, 20 of 31 patients, respectively). In 59 sections examined precisely, 43 sections showed zonal atrophy of the gastric glands. More than half of these zones (25 of 44 zones) did not overlap with 4 mm-long SCJ zones. In the latter zones, stratified columnar epithelia, epithelial islands, and PALC were observed more frequently, although intestinal metaplasia was not. These data suggested that the occurrence of PALC is correlated with the anatomical site, i.e. SCJ, but not with such ill conditions, i.e. atrophic gastritis or gastric cancer. PALC in the SCJ may be orthotopic.

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