대장 림프양 증식증의 내시경 소견과 임상적 특징

Abstract

Background : There have been known a few endoscopic studies of colonic lymphoid hyperplasia. The various findings of colonic lymphoid nodules may nevertheless cause confusion with other endoscopic diagnosis and their clinicopathologic significance have not been well known until now. The aims of this study were to classify the colonic lymphoid hyperplasia accordings to the colonoscopic findings and to reveal the clinicopathological relationship. Methods : From January 1998 to December 2000, 35 cases of colon lymphoid hyperplasia were selected in this study, the patients who had any other colon diseases were excluded in initial study group. We evaluated the endoscopic features of colonic lymphoid hyperplasia and analyzed their clinicopathologic relationships. Results : Colonic lymphoid hyperplasia was endoscopically classified as follows: 18 Polyps, 7 Target lesions, 5 Verrucous lesions, 5 Erosions. The rectum and cecum were most frequently involved. The histological grades of colonic lymphoid hyperplasia were divided into grade I (19 cases), grade II (13 cases), graded III (3 cases) according to degree of lymphatic follicle and lymphocyte infiltration to interstitial tissue. The severity of histologic grades had a tendency to increment in verrucous or erosive lesion comparing with polyp or target lesion, but they had no significant relation with other endoscopic or clinical features. Conclusion : Colonic lymphoid hyperplasia can be classified endoscopically into four types. Verrucous or erosive lesion might be considered as more severe colonic lymphoid hyperplasia. Further prospective and long-term studies are needed to confirm clinicopathologic significance of various endoscopic features.