A P,ATHOHISTOLOGICAL STUDY ON THE INTESTINAL EPITHELIAL METAPL,ASIA IN GASTRIC MUCOSA Ken Kubota Department of Pathology, Showa Medical School (Direct

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1 A P,ATHOHISTOLOGICAL STUDY ON THE INTESTINAL EPITHELIAL METAPL,ASIA IN GASTRIC MUCOSA Ken Kubota Department of Pathology, Showa Medical School (Director : Prof. Ichiro Hirafuku)

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6 2) Moskowicz, L.: Regeneration and Krebsbildung an der Magenschleimhaut. Arch. Kim. Chir., 132, , ) Konjetzny, G. E.: Ueber die Bezihung der chronischen Gastritis mit ihren Folgeerscheinungen and des Magenkrebses. Bruno Beitrage z. Kim. Chir., 85, , ) Morson, B. C.: Carcinoma arising from areas of intestinal metaplasia in the gastric mucosa. 1058

7 昭 和35年1月30日 写 真1著 51 明 な6tatmamelonn6を 示す 写 真2写 胃 粘 膜. 真1の 染 色IH-E染 組 織 像.Haematoxylin-Eosln 色 の 場 合 は 以 下 略 す).間 質 の増 殖 と瀰 漫 性 に み ら れ る 化 生 腸 上 皮. 写 真3元 来 胃底 腺 の あつ た部 に広 汎 な腸 上 皮 化 生 が 起 き て い る.そ 写 真4写 の底 部 に崩 壊 に頻 し た 胃 底 腺 の 一 部 が み られ る.但 真3のPAS-Haematoxylin染 (後 染 色 のHaematoxylinの しこ の残 存 胃 PAS染 色, 字 句 は 以 下 略 す). 色 陰 性 で あ る が,一 部 の も のは そ の腺 底 腺 そ の も の も変 化 し て い て,大 部 分 が 旁 細 胞 か ら成 つ て い る.そ の 核 は 濃 縮 性 で,細 胞 腟 に 面 した所 に細 顆粒 状 の 陽性 物 質 を 少量 認 め る.こ の 顆 粒 は 他 の腺 細 胞 の 陽 性 顆 粒 と は 質 は 空 胞 状 に な つ て い る. 形 態 が 全 く異 つ て い る が,そ の意 義 は よ くわ か つ て い な い. 写 真5連 続 切 片に よ つ て化 生 腸 上 皮 につ な 写 真6写 が るこ とが 証 明 され た 胃 底腺 部 に残 存 して い る主 細 胞.主 真5のPAS染 色 で,こ 群 は 染 色 成 績 は 陰 性 で あ る. 細 胞 の 構 造 が や や 乱 れ て い る の主 細 胞

8 昭和医学会雑 誌 52 写 真8過 写真7胃 粘 膜 の糜 爛 部 に新 生 しつ つ あ る腸 上 皮. 第19巻 第11号 剰 増殖 を 示 す化 生 腸 上 皮 と不 完 全 な 化 生 腸 と考 え られ る もの 中央 右 よ りの 腺 窩 の 向 つ て 左 側 の 一 層 の背 の 低 い上 皮. 写真10化 生 腸 上 皮 か ら成 る腺 底 部 に み られ る核 分 剖 を 示 す 細 胞. 写 真9胃 小 窩 上 皮細 胞 の 間 に挾 まつ て 存 在 す る腸 上 皮 細 胞. 写 真11偽 写 真12化 幽 門 腺 細 胞 の 間 に み られ た Paneth糸 田胞. 生 腸 上 皮 腺 窩 の 浅 い部 に み られ たPaneth細 1060 胞.

9 53 昭 和35年1月30日 写 真13腺 写 真14写 底 部 に ム コ イ ド腺 の み ら 真13のPAS染 色. れ な い 腸 上 皮 化 生. 写 真15写 真13の 写 真16写 連 続 切 片 に よ り化生 真15のPAS染 色. 腸 上 皮 腺 窩 に ム コ イ ド腺 の 接 続 が み ら れ る も の の あ る こ と を 示 す. 写 真17粘 膜 筋 板 の筋 線 維 の下 にみ 写 真18写 られ る ム コ イ ド腺. 真17の 連 続 切 片 に よ り上 方 の 化 生 腸 上 皮 と つ な が る ム コ イ ド腺. 1061

10 54 昭和医学会雑 誌 写 真19粘 膜 筋 板 を へ だ て て み られ 写 真20写 る 偽 ブ ル ン ネ ル 腺. 写 真21写 真19の 第19巻 真19のPAS染 第11号 色で 陽 性 を 示 す. 連続切 片に より粘膜 写 真22写 筋 板 を つ らぬ い て 化 生 腸 上 皮 に つ な が つ 真21のPAS染 色で 陽 性 を 示 す. て い る の が 証 明 さ さ る. 写 真23胃 写真24副 底 腺 部 に み られ た 副 細 胞 化 生. 中 央 下 方 に 明 る くみ え る の が 増 生 し た 副 細 胞 変 性 のPAS染 色.陽 性 を 示 す の が 副 細 胞 で あ る. 細 胞.残 存 す る 旁 細 胞 は 少 く,又 副 細 胞 に 接 し て 主 細 胞 に 形 態 が 近 い が,細 胞質 が 淡 く染 ま つ て い る も の を 認 め る. 1062

11 Brit, Jour. Cancer, 9, (3), , ) Ota, K.: On g metaplastic gastritis h. Some consideration of its histogenesis, Gann., 41, 72-75, ) Hirafuku, I.: Some consideration on the pathological changes of the gastric mucosa. Acta Path. Jap., 7, (SuppL), , ) Morson, B. C.: Intestinal metaplasia of the gastric mucosa. Brit, Jour. Cancer., 9, (3), , ) Arey, L. B.: On the occurrence of epithelium and gland of the intestinal type in the gastric mucosa. Surg. Gyne, and Obst, 90, (1), 86-90, ) Chuma, M.: Zur normalen and pathologischen Histologie der Magenschleimhaut. Virchows Arch., 247, , ) Konjetzny, G. E.: Die EntzUndung des Magens. Handb, spez. path. Anat, and Hist. IV 2, , ) Murakami, T.: A histological study on the mechanism of intestinal epithelial metaplasia in gastric mucosa. Gann., 48, March, 9-14, ) Hamperl, H.: Ueber erworbene Heterotopien ortfremden Epithels in Magen-Darmtrakt. Beitr. Path. Anat, 80, , ) Patzet : Die oxyphilen Panethschen Kornchenzellen. Mollendorff ; Handbuch der Mikroskopischen Anatomie des Menschen, V/3, , ) Lyson, L.: Histochimie et Cytochimie, 4R, , Intestinal epitherial metaplasia was observed on the gastric mucoua at the portion of pyloric antrum in 60%, namely, 30 out of 50 cases examined. 2. In regard to the Paneth cell, which is observed on the metaplastic intestinal epithelium descriptions were made that it sometimes shows atypical appearance, that it is the clue to show the relationship of intestinal epitherial metaplasia and mucoid gland, or that it is the indication of active metaplasia, and further that it appears to be closely related with the bifurcation of intestinal epithelial metaplasia. 3. The intestinal epitherial metaplasia was divided into duodenal type, jejunal type, ileal type and colonic type on the basis of the presence of mucoid gland and Paneth cell. 4. Cells of the pyloric gland, Brunner's gland, pseudo-pyloric gland, pseudo-brunner's gland and the accesory cells of the f undus gland were found th show identical charcteristics on varying staining tests. Since the content of those cells, moreover, gave the characteristics of mucoid substance, it is proposed to call the glands formed by those cells as mucoid glands. 5. Attention was invited to the fact the stained samples of pseudopyloric gland gave considerably different pictures depending on the section examined. 6. Descriptions were mad that shapes of pseudo-pyloric gland is variant and, in and extreme case, it was seen as the mere grouping of a few mucoid cells at the base of the metaplastic intestinal epithelium being deficient of any lumen. 7. A proof was given on the possibility of the connection of mucoid gland located under the mucous muscle seemingly left over by the follow-up made with serial sections. 8. Development of the pseudo-pyloric gland was shown to be closely related wit the metaplasia of accessory cell. 1063

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