Tada S, Iida M, Iwashita A, Matsui T, Fuchigami T, Yamamoto T, Yao T, Fujishima M
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Gastrointest Endosc. 1990 Jan-Feb;36(1):10-4. doi: 10.1016/s0016-5107(90)70913-3.
Endoscopic and biopsy findings of the esophagus, stomach, duodenum, and colorectum were studied in 37 patients with amyloidosis involving the gastrointestinal tract. Endoscopic examinations revealed fine granular appearance, polypoid protrusions, erosions, ulcerations, and mucosal friability in many cases. These findings were most marked and noticed most often in the second portion of the duodenum. The frequency of amyloid deposition in the biopsy specimens was as follows; 100% in the duodenum, 95% in the stomach, 91% in the colorectum, and 72% in the esophagus. The degree of amyloid deposition in the duodenum, which was the highest of the entire gastrointestinal tract, significantly correlated with the frequency of endoscopic findings such as fine granular appearance and polypoid protrusions. Therefore, the two endoscopic findings described above are characteristic of this disease and may reflect amyloid deposition in the mucosa or submucosa of the alimentary tract. Our results indicate that for a diagnosis of amyloidosis, it is important to examine the upper gastrointestinal tract, especially the duodenum, using endoscopy and biopsy techniques.
对37例累及胃肠道的淀粉样变性患者的食管、胃、十二指肠和结肠直肠进行了内镜及活检检查。内镜检查发现，许多病例中可见细微颗粒状外观、息肉样隆起、糜烂、溃疡及黏膜脆性增加。这些表现以十二指肠降部最为显著且最为常见。活检标本中淀粉样蛋白沉积的频率如下：十二指肠为100%，胃为95%，结肠直肠为91%，食管为72%。十二指肠的淀粉样蛋白沉积程度在整个胃肠道中最高，与细微颗粒状外观和息肉样隆起等内镜表现的频率显著相关。因此，上述两种内镜表现为此病的特征，可能反映了消化道黏膜或黏膜下层的淀粉样蛋白沉积。我们的结果表明，对于淀粉样变性的诊断，采用内镜及活检技术检查上消化道，尤其是十二指肠，非常重要。
