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		<h1 class="catchCopy">縦隔腫瘍・胸膜腫瘍の病理診断における座右の書！待望の改訂版!!</h1>
		

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		<h1 class="title">縦隔腫瘍・胸膜腫瘍<span class="version">第2版</span></h1>
		

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					編集：松野吉宏（北海道大学教授）
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					<span class="transparent">編集</span>　鍋島一樹（福岡大学教授）
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					編集協力：日本病理学会
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">腫瘍病理鑑別診断アトラスシリーズ「縦隔腫瘍・胸膜腫瘍」，待望の第2版．2014年の初版発行から8年，2021年にはWHO分類第5版が刊行され，当該領域の臨床・病理を取り巻く環境は日々変化している．そうした状況を踏まえて，胸部腫瘍病理のエキスパートたちが精選した病理写真とともに，定義や概念，診断上の要点を解説した．縦隔腫瘍・胸膜腫瘍病理診断の標準化を図りつつ鑑別ポイントをも網羅し，さらに，臨床との連携では欠かせないX線所見のみかたや治療法も解説した．希少症例が多い縦隔・胸膜領域の病理診断において即戦力となる．</section><section class="preface">第2版の序<br><br>　日本病理学会編集協力「腫瘍病理鑑別診断アトラス」のシリーズ企画として「縦隔腫瘍・胸膜腫瘍」が発刊されてから8年の歳月が過ぎた．幸い信頼を得て愛用される参考書のひとつとなって久しいが，この年月の間にもこれらの腫瘍の病態の研究や疾病概念の整理はたゆまず進められてきた．<br>　この度，胸部領域の腫瘍群について標準を示すWHO分類が第5版へと改訂された．今回の改訂では，従来から採用されているmultidisciplinary approachの役割が一層重要性を増し，疾患単位<br>のとらえ方をはじめ，変貌する臨床ニーズに対応する方向性が示されている．本シリーズではこの機会をとらえ，この領域での新たな標準を俯瞰できる成書として「縦隔腫瘍・胸膜腫瘍」第2版を刊行する運びとなった．<br>　縦隔は決して広い臓器領域ではないが，実に多様な腫瘍が一定の頻度で発生することで知られ，個別の診断にあたっても鑑別対象のなかには癌腫やリンパ腫，胚細胞腫瘍，肉腫など治療方針の大きく異なる腫瘍や非腫瘍性疾患が広く含まれるのが常と言ってよい．これらを正しく見極めて診断し，最適な治療選択に導くことは病理診断の醍醐味でもあるが，そのためには十分な知識を基盤としてその可能性や限界を熟知しておく必要がある．新たなWHO分類では，従来からよく知られてきた腫瘍の新しい分子病理学的特性，疾患単位の見直し，他臓器にも発生する同系腫瘍との概念の整合性など，種々の観点から疾患群の再整理が行われた．<br>　胸膜腫瘍の代表である中皮腫による死亡者数は2000年以降急激に増加し，今後10～20年後にピークを迎えると予想されている．病理医にとって今後さらに診断機会も増え，加えて確実な早期診断が求められている．今回のWHO分類改訂に先だって，国内でも「中皮腫瘍取扱い規約」が2018年11月に初めて発刊された．中皮腫の遺伝子変異に基づく補助アッセイの確立によってmesothelioma <i>in situ</i>の診断が可能となり，予後規定因子やgradingが求められ，生検と手術材料の違いによる診断名の使い分けも記載されるなど，病理医にはその診断や所見記載に十分な理解が求められている．<br>　本書のなかでは，これらのupdateを含めた標準的な情報が可能な限り実例とともに解説される．本書が常に病理医の座右におかれ，日々の困難な診断局面においても正確で有用な情報を臨床へ提供する助けとなることを願ってやまない．<br><br>　令和4年3月<br>　松野　吉宏<br>　鍋島　一樹<br><br><br>　この「腫瘍病理鑑別診断アトラスシリーズ」は日本病理学会の編集協力のもと，刊行委員会を設置し，本シリーズが日本の病理学の標準的なガイドラインとなるよう，各巻ごとの編集者選定をはじめ取りまとめを行っています．<br><br>　腫瘍病理鑑別診断アトラス刊行委員会<br>　小田義直，坂元亨宇，都築豊徳，深山正久，松野吉宏，森谷卓也</section><section class="indexes">［縦隔腫瘍］<br>第1部　検鏡前の確認事項<br>　Ⅰ．縦隔腫瘍－WHO分類 第5版（2021）のコンセプト<br>　Ⅱ．病理標本の扱い方：検体の取扱い　<br><br>第2部　組織型と診断の実際<br>　Ⅰ．胸腺上皮性腫瘍<br>　　1．胸腺腫<br>　　（1）A型（異型A型を含む），B型，AB型，B1型，B2型，B3型胸腺腫<br>　　（2）リンパ性間質を伴う小結節性胸腺腫，化生性胸腺腫，脂肪線維腺腫，いわゆる顕微鏡的胸腺腫といわゆる硬化性胸腺腫<br>　　2．胸腺癌<br>　　（1）扁平上皮癌　<br>　　（2）類基底癌　<br>　　（3）リンパ上皮癌<br>　　（4）NUT癌<br>　　（5）明細胞癌　<br>　　（6）低異型度乳頭状腺癌　<br>　　（7）粘表皮癌<br>　　（8）腺様嚢胞癌様胸腺癌<br>　　（9）腸型腺癌　<br>　　（10）腺癌，NOS　<br>　　（11）腺扁平上皮癌　<br>　　（12）肉腫様癌<br>　　（13）未分化癌　<br>　Ⅱ．胸腺神経内分泌腫瘍<br>　Ⅲ．胚細胞腫瘍<br>　Ⅳ．血液・リンパ増殖性病変<br>　Ⅴ．神経原性腫瘍<br>　Ⅵ．胸腺および縦隔の軟部腫瘍<br>　Ⅶ．転移性腫瘍<br>　Ⅷ．腫瘍様病変，過誤腫<br>　　1．嚢胞性病変<br>　　2．増殖性病変（胸腺過形成・異所性過誤腫性胸腺腫）<br>　　3．異所性甲状腺・異所性副甲状腺病変<br><br>第3部　鑑別ポイント<br>　Ⅰ．生検標本の診断<br>　Ⅱ．胸腺腫の浸潤の評価（臨床との応用）　<br>　Ⅲ．B3型胸腺腫と胸腺癌の鑑別<br>　Ⅳ．混合型胸腺上皮性腫瘍の診断<br>　Ⅴ．嚢胞性病変の鑑別診断<br><br>第4部　臨床との連携<br>　Ⅰ．術前診断<br>　Ⅱ．臨床病態<br>　Ⅲ．治療<br>　Ⅳ．病理診断報告書の記載<br><br>［胸膜腫瘍］<br>第1部　検鏡前の確認事項<br>　Ⅰ．中皮腫瘍取扱い規約とWHO分類 第5版（2021）のコンセプト<br>　Ⅱ．病理標本の扱い方<br>　　1．胸膜生検, 細胞診セルブロック<br>　　2．手術材料の取扱い　<br><br>第2部　組織型と診断の実際　<br>　Ⅰ．中皮細胞腫瘍<br>　　1．良性腫瘍と前浸潤性病変<br>　　（1）アデノマトイド腫瘍<br>　　（2）高分化乳頭状中皮腫瘍<br>　　（3）Mesothelioma <i>in situ</i>（前浸潤性中皮腫）<br>　　2．悪性腫瘍<br>　　（1）びまん性中皮腫（上皮型, 肉腫型（線維形成性を含む）, 二相型）　<br>　　（2）局在型中皮腫　<br>　Ⅱ．リンパ腫<br>　　1．原発性体腔液リンパ腫<br>　　2．慢性炎症関連びまん性大細胞型B細胞リンパ腫<br>　Ⅲ．転移性腫瘍　<br>　Ⅳ．非上皮性腫瘍<br>　Ⅴ．腫瘍様病変<br><br>第3部　鑑別ポイント<br>　Ⅰ．反応性中皮増殖と中皮腫の鑑別<br>　Ⅱ．中皮腫と肺癌の胸膜浸潤との鑑別　<br><br>第4部　臨床との連携<br>　Ⅰ．中皮腫の画像所見<br>　Ⅱ．細胞診の有用性<br>　Ⅲ．中皮腫の治療<br>　Ⅳ．病理診断報告書の記載<br>　　1．生検検体<br>　　2．手術検体<br><br>索引</section></article>
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