Cap polyposisの1例  [in Japanese] A CASE OF CAP POLYPOSIS  [in Japanese]

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今回われわれは,比較的新しい概念の疾患であるcap polyposisの1例を経験したので報告する.症例は21歳,男性.主訴は,下血.既往歴として, 14歳時,下血を主訴にポリープ切除術を受けている. 18歳頃から再び下血し,近医よりvillous tumorを疑われ,当科紹介された.注腸検査では,肛門縁直上から約6~7cm口側にわたる全周性の病変で,表面に粗大な隆起が多発しており,腫瘤性病変かポリープの集籏病変かの判別は困難であった.内視鏡検査では,表面が白色付着物に覆われた多数の隆起性病変を認めた.隆起性病変の間には正常粘膜が介在し,炎症あるいはその他の原因による多発性ポリープの像を呈していた.経肛門的ポリープ切除による病理組織学的検査では,帽子状の肉芽組織に覆われており,炎症性過形成性ポリープと診断された.以上の検査所見からcap polyposisと診断し,保存的に経過をみたところ,下血症状はほぼ消失し, 2カ月後の再検では所見の悪化を認めていない.

This paper presents a case of cap polyposis which is a new concept of the disease. A 21-year-old man was admitted to the hospital because of bloody stool lasting for over recent 3 years. He had been suspected having a villous tumor at the rectum by other doctor. He had a past history of undergoing a rectal polypectpmy with the chief complaint of bloody stool at the age of 14. Barium enema showed a whole circumferential lesion covering about 6-7cm from the anal verge and multiple elevated lesions on its surface. Colonoscopy showed multiple polypoid lesions covered with whitish exudate with intervening normal mucosa. In a histopathological examination of the specimens obtained by a transanal polypectomy, it was covered with a ‘cap’ of fibrous granulative tissue and diagnosed as inflammatory hyperplastic polyp. Based on these findings, we diagnosed the case as cap polyposis and dicided to observe conservatively. Thereafter his symptom almost vanished and no aggravation was revealed at a follow-up examination conducted 2 months after the treatment.


  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 63(2), 435-438, 2002-02-25

    Japan Surgical Association

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Cited by:  2


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