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		<h1 class="catchCopy">悪性軟部腫瘍病理診断のスタンダード！最新の知見を盛り込んだ，待望の改訂版!!</h1>
		

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					編集：長谷川匡（札幌医科大学教授）
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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「悪性軟部腫瘍」，待望の改訂・改題第2版．軟部腫瘍はその種類が極めて多いが，本書では「悪性軟部腫瘍」に焦点を絞り，頻度の高い重要な組織型を中心に解説した．鑑別診断において重要となる良性や中間群についても取り上げている．WHO分類第5版（2020）の内容や，遺伝子学的知見などの最新の知見を交じえながら，精選した病理写真とともに診断のポイントを解説．悪性軟部腫瘍病理診断のスタンダードを示す1冊であり，病理医はもちろん，悪性軟部腫瘍の診断・治療に携わるすべての医師必携の書．</section><section class="preface">第2版の序<br><br>　軟部腫瘍の組織型分類は非常に多岐にわたり，名称の変更や新たな腫瘍概念の提唱が頻繁に行われている．特に悪性軟部腫瘍においてはその希少性も相まって軟部腫瘍を専門としない病理医にとっては苦手な分野の一つであると考えられる．しかし，近年の「希少がん」教育の啓発活動もあり，悪性軟部腫瘍の診断はこれらを専門としない病理医にとっても避けては通れない分野になりつつある．<br>　最近の世界的な軟部腫瘍の分類としては，2020年出版のEnzinger &amp; Weiss’s Soft Tissue Tumors 第7版やWHO分類第5版が世界的なスタンダードとなっている．改訂されたWHO分類は新規の腫瘍概念や腫瘍の分子病理学的知見が反映されたより一層充実した内容となっている．<br>　軟部腫瘍はその種類が極めて多く，その全てを網羅するのは限られた紙面では不十分であり，また軟部腫瘍病理の羅列的な学習は非効率的であり実践的でない．したがって本書では第2部において悪性軟部腫瘍を中心に鑑別診断上重要な良性，中間群腫瘍も含め，比較的頻度の高い重要な組織型について，WHO分類の内容を反映させて詳述している．この各論では腫瘍の形態学的特徴のみならず，最新の遺伝子学的知見も交えながら解説し，本書を手に取った読者が腫瘍概念を包括的に理解できるよう心掛けている．<br>　軟部腫瘍の確定診断には様々な鑑別診断を念頭に置いた診断のアルゴリズムが欠かせない．その過程においては腫瘍の形態像のみならず，免疫組織化学や遺伝子学的検索も駆使した総合的な病理学的アプローチが要求される．本書の第3部では腫瘍の形態観察を主軸に据えつつも免疫組織化学や遺伝子学的検索も加味した鑑別診断について述べている．<br>　軟部腫瘍の診断・治療にあたっては病理医，放射線科医，外科医，内科医，小児科医などの密接な連携が必要不可欠である．適切な早期治療の開始に際しても腫瘍の正確な病理診断は必須であり，融合遺伝子検出は転座関連肉腫においては確定診断の強力な補助的手段として日常診断で用いられている．本書の第4部では軟部腫瘍診療の臨床的観点から軟部肉腫の進行期と治療方針・予後，薬物療法の実際，画像診断のポイント，さらには軟部腫瘍の遺伝子診断と新たな遺伝子学的解析方法について記載している．<br>　本書がわが国の軟部腫瘍病理診断の向上に寄与する標準的なガイドラインとして，病理医はもちろんのこと軟部腫瘍の診断・治療に携わる多くの医療従事者にとって必携のアトラスとなりえれば幸いである．<br><br>　令和3年3月<br>　長谷川　匡<br>　小田　義直<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，深山正久，松野吉宏，森永正二郎，森谷卓也</section><section class="indexes">第1部　検鏡前の確認事項<br>　Ⅰ．軟部腫瘍の組織型分類：WHO分類について<br>　　1．2020年軟部腫瘍WHO分類（第5版）の特徴<br>　　2．細胞分化に基づいた大分類の詳細<br>　Ⅱ．病理標本の取扱い方<br>　　1．検体採取と固定までの取扱い<br>　　2．固定標本の肉眼観察と切り出し<br>　　3．染色，遺伝子検索<br><br>第2部　組織型と診断の実際<br>　Ⅰ．脂肪性腫瘍<br>　　1．異型紡錘形細胞/多形脂肪腫様腫瘍<br>　　2．脂肪肉腫<br>　Ⅱ．線維芽細胞および筋線維芽細胞腫瘍<br>　　1．デスモイド線維腫症<br>　　2．隆起性皮膚線維肉腫<br>　　3．孤立性線維性腫瘍<br>　　4．炎症性筋線維芽細胞腫瘍<br>　　5．粘液線維肉腫<br>　　6．低悪性線維粘液性肉腫/硬化性類上皮線維肉腫<br>　Ⅲ．脈管性腫瘍<br>　　1．偽筋原性血管内皮腫<br>　　2．類上皮血管内皮腫<br>　　3．血管肉腫<br>　Ⅳ．平滑筋性腫瘍<br>　　1．EBV関連平滑筋腫瘍<br>　　2．平滑筋肉腫<br>　Ⅴ．骨格筋性腫瘍<br>　　1．横紋筋肉腫<br>　Ⅵ．末梢神経性腫瘍<br>　　1．悪性末梢神経鞘腫瘍<br>　Ⅶ．分化不明腫瘍<br>　　1．筋肉内粘液腫<br>　　2．類血管腫線維性組織球腫<br>　　3．筋上皮腫/筋上皮癌/混合腫瘍<br>　　4．高リン尿性間葉系腫瘍<br>　　5．<i>NTRK</i> 遺伝子再構成紡錘形細胞腫瘍<br>　　6．滑膜肉腫<br>　　7．類上皮肉腫<br>　　8．胞巣状軟部肉腫<br>　　9．軟部明細胞肉腫<br>　　10．骨外性粘液型軟骨肉腫<br>　　11．線維形成性小円形細胞腫瘍<br>　　12．ラブドイド腫瘍<br>　　13．血管周囲類上皮細胞腫瘍<br>　　14．未分化肉腫<br>　Ⅷ．骨軟部発生未分化小円形細胞肉腫<br>　　1．<i>EWSR 1-non ETS</i> 融合遺伝子陽性肉腫<br>　　2．<i>CIC</i> 遺伝子再構成肉腫<br>　　3．<i>BCOR</i> 遺伝子異常肉腫<br><br>第3部　鑑別ポイント<br>　Ⅰ．紡錘形細胞肉腫<br>　　1．有用と思われる前提知識<br>　　2．代表的疾患の組織学的・免疫組織化学的特徴<br>　　3．常に鑑別候補に含めておくべき疾患<br>　　4．診断に難渋する場合<br>　　COLUMN　紡錘形腫瘍細胞の形態による分化方向の推定と主な配列パターン<br>　Ⅱ．小円形細胞腫瘍<br>　　1．Ewing肉腫<br>　　2．Ewing様肉腫<br>　　3．線維形成性小円形細胞腫瘍<br>　　4．胎児型横紋筋肉腫<br>　　5．胞巣型横紋筋肉腫<br>　Ⅲ．多形肉腫<br>　　1．高悪性度多形肉腫という概念<br>　　2．多形型平滑筋肉腫<br>　　3．多形型横紋筋肉腫<br>　　4．多形型脂肪肉腫<br>　　5．未分化多形肉腫<br>　　6．高悪性度多形肉腫のゲノム<br>　　7．高悪性度多形肉腫の鑑別診断の実際<br>　Ⅳ．粘液性腫瘍<br>　　1．軟部腫瘍における粘液腫状変化について<br>　　2．表在性（主に真皮内）の病変<br>　　3．主に皮下の粘液性腫瘍<br>　　4．深在性粘液性腫瘍<br>　Ⅴ．上皮様腫瘍<br>　　1．類上皮血管肉腫<br>　　2．二相型滑膜肉腫<br>　　3．ラブドイド腫瘍<br>　　4．類上皮肉腫<br>　Ⅵ．筋線維芽細胞増殖性病変<br>　　1．結節性筋膜炎<br>　　2．反応性および良性増殖性病変の鑑別診断<br>　　3．主な鑑別すべき病変<br>　　4．いわゆる炎症性偽腫瘍について<br>　Ⅶ．良性末梢神経腫瘍<br>　　1．Schwann細胞腫<br>　　2．神経線維腫<br>　　3．神経周膜腫<br>　　4．顆粒細胞腫<br>　　5．皮膚神経鞘粘液腫<br>　　6．孤在性限局神経腫<br>　　7．混成性神経鞘腫瘍<br><br>第4部　臨床との連携<br>　Ⅰ．病理診断報告書の記載<br>　　1．病理診断報告書の構成<br>　　2．病理診断<br>　　3．病理診断所見（コメント）<br>　　4．FNCLCC Grading System<br>　Ⅱ．軟部肉腫の進行期と治療方針・予後<br>　　1．軟部肉腫の病期分類の概要<br>　　2．AJCC/UICC staging system（8th edition）<br>　　3．Surgical Staging System（SSS）<br>　　4．Memorial Sloan Kettering Cancer Center（MSKCC）の分類<br>　　5．軟部肉腫の進行期と予後<br>　　6．軟部肉腫の進行期別治療法<br>　　7．軟部肉腫の進行期分類と治療の実際<br>　　8．まとめ<br>　Ⅲ．軟部肉腫の薬物療法<br>　　1．抗悪性腫瘍薬に高い感受性をもつと考えられている肉腫<br>　　2．抗悪性腫瘍薬に相対的に低い感受性をもつと考えられている肉腫（その他の肉腫）<br>　　3．開発中の分子標的治療薬について<br>　Ⅳ．軟部肉腫の画像診断<br>　　1．単純X線写真<br>　　2．超音波検査<br>　　3．CT<br>　　4．MRI<br>　　5．核医学検査（FDG-PET）<br>　　6．病理診断と画像の相関―MRIを中心に―<br>　　7．病理診断と画像検査の相補関係<br>　Ⅴ．軟部腫瘍の遺伝子診断と新たな遺伝学的解析方法<br>　　1．軟部腫瘍診療における遺伝子診断の意義<br>　　2．軟部腫瘍における遺伝子診断の対象<br>　　3．遺伝子診断の実際<br>　　4．遺伝子診断結果の取り扱いと病理学的手法を用いた評価<br>　　5．今後の展望<br>　Ⅵ．軟部肉腫の組織学的治療効果判定と切除縁評価<br>　　1．組織学的治療効果判定<br>　　2．切除縁評価<br><br>索引</section></article>
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