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<meta name="description" content="小児がんは，成人のがんとは異なる病態を示し，進行も早いため，迅速かつ的確な病理診断が求められる．さらに組織型を決定するだけではなく，治療方針や予後を明確にするための亜分類も必要になることがある．　そこで本書では小児・AYA世代に好発する腫瘍，稀ではあるが小児期特有の腫瘍を中心に，組織型の診断，適切なリスク分類，予後予測，さらに治療選択につなげるべく重要な知識を臓器横断的にエキスパートが解説した．　">

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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">小児がんは，成人のがんとは異なる病態を示し，進行も早いため，迅速かつ的確な病理診断が求められる．さらに組織型を決定するだけではなく，治療方針や予後を明確にするための亜分類も必要になることがある．<br>そこで本書では小児・AYA世代に好発する腫瘍，稀ではあるが小児期特有の腫瘍を中心に，組織型の診断，適切なリスク分類，予後予測，さらに治療選択につなげるべく重要な知識を臓器横断的にエキスパートが解説した．<br>WHO分類第5版「Paediatric Tumours」にも対応した，小児腫瘍病理の決定版アトラス．</section><section class="preface">序　文<br><br>　小児腫瘍のなかでも悪性腫瘍である小児がんは代表的な希少がんの一つであり，本邦では年間2,000〜2,500例程度の発生頻度に過ぎないが，全身の様々な臓器に多種多様なかたちで発生する．極めて稀な腫瘍型も多く，個々の病理医が現場で経験する機会に乏しいのが現状であるが，5歳以上の病死原因の第1 位は小児がんであり，小児医療では重要な位置を占める．小児がんのなかでも，新生児から乳幼児に好発する胎児性腫瘍では，器官原基を発生母地とし，未熟な細胞の密な増生巣と器官形成を模倣する構造が観察され，年齢に応じた分化・成熟能を保持しており，成人期のがんとは異なる病態を示す．一般的に進行が速く，迅速かつ的確な病理診断が極めて重要であり，組織型のみならず，種々のリスク分類が求められる腫瘍型も多い．治療方針の決定には臨床病期や組織型に加えて，リスク層別化のため遺伝子異常を含む種々のバイオマーカーの検索が重要となっており，病理医にとっても分子遺伝学的な知識が必要である．<br>　WHO分類第4版までは小児腫瘍は各臓器の分類に個別に収載されていたが，WHO分類第5版になり，小児腫瘍が初めて独立して取り上げられた．小児がんのみならず，良性腫瘍や成人期にもみられる腫瘍型を含む膨大な数の組織型が収載され，2022年に二分冊として発刊された．そこには，疫学的事項や画像所見，腫瘍発生に関連する分子遺伝学的背景，病理所見，鑑別診断，予後などが漏れなく記載されており，小児腫瘍の病理診断に際して参照すべき十分な内容が盛り込まれている．このような背景のなか，腫瘍病理鑑別診断アトラスでは初めて臓器横断的な内容となる小児腫瘍に特化した本書が発刊の運びとなった．<br>　本書では，主に成人期に発生する腫瘍は臓器別のアトラスに譲り，小児腫瘍を目にした際に現場の病理診断に役立つような視点で，小児・AYA 世代に好発する腫瘍，稀ではあるが小児期特有の腫瘍を中心に取り上げた．第1部では，小児腫瘍の特徴や疫学的事項，および病理医が知っておくべき登録制度や標本の取り扱いを簡潔に記載し，第2部は，多種多様な腫瘍型について特徴的な肉眼像や組織像を提示しながら，診断に必要な分子遺伝学的内容も取り上げ，本書の骨格ともいうべき部分である．第3 部では，臨床研究の基盤であるグループスタディや小児腫瘍の臨床的特徴，さらに早期診断・治療の重要性，遺伝性腫瘍への対応，ゲノム医療について，第一線の臨床の先生方に概説していただいた．本書が小児腫瘍の病理診断の現場で，組織型の診断，適切なリスク分類，予後予測，さらに治療選択につながる役割を果たすことを期待する．<br><br>令和8年1月<br>井上　健<br>大喜多　肇<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<br>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<br>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，前田大地，森谷卓也</section><section class="indexes">第1部　検鏡前の確認事項<br>　Ⅰ．小児腫瘍の特徴─疫学的事項と分子遺伝学的特徴など─<br>　Ⅱ．病理医が知っておくべき登録制度と標本の取扱い<br><br>第2部　組織型と診断の実際<br>　Ⅰ．造血器腫瘍<br>　　1　若年性骨髄単球性白血病<br>　　2　Down 症候群関連骨髄腫瘍<br>　　3　リンパ芽球性白血病/リンパ腫<br>　　4　IRF4 再構成を伴う大細胞型B 細胞リンパ腫<br>　　5　小児型濾胞性リンパ腫<br>　　6　小児節性辺縁帯リンパ腫<br>　　7　Burkitt リンパ腫<br>　　8　11q 異常を伴う高悪性度B 細胞リンパ腫<br>　　9　ALK 陽性未分化大細胞リンパ腫<br>　　10　古典的Hodgkin リンパ腫<br>　　11　結節性リンパ球優位型Hodgkin リンパ腫<br>　　12　Langerhans 細胞組織球症，その他の組織球症<br>　　13　先天性免疫異常関連リンパ増殖症およびリンパ腫<br>　Ⅱ．中枢神経系腫瘍<br>　　1　小児型びまん性膠腫<br>　　2　限局性星細胞系膠腫<br>　　3　グリア神経細胞系および神経細胞系腫瘍<br>　　4　上衣系腫瘍・脈絡叢腫瘍<br>　　5　胎児性腫瘍<br>　Ⅲ．神経芽腫群腫瘍ならびに網膜芽細胞腫<br>　　1　神経芽腫群腫瘍<br>　　2　網膜芽細胞腫<br>　Ⅳ．骨軟部腫瘍ならびに腫瘍類似病変<br>　　1　乳児線維性過誤腫<br>　　2　乳幼児線維腫症<br>　　3　乳児線維肉腫<br>　　4　小児NTRK 再構成紡錘形細胞腫瘍<br>　　5　脈管性腫瘍ならびに脈管奇形<br>　　6　横紋筋肉腫<br>　　7　腎外ラブドイド腫瘍<br>　　8　線維形成性小円形細胞腫瘍<br>　　9　Ewing 肉腫およびその他の骨軟部未分化小円形細胞肉腫<br>　　10　胸壁軟骨間葉性過誤腫<br>　　11　軟骨芽細胞腫<br>　　12　間葉性軟骨肉腫<br>　　13　線維性（骨）異形成<br>　Ⅴ．胚細胞腫瘍ならびにその他の小児卵巣腫瘍<br>　　1　小児精巣胚細胞腫瘍<br>　　2　小児卵巣胚細胞腫瘍<br>　　3　性腺外胚細胞腫瘍<br>　　4　Fetus in fetu<br>　　5　性索間質性腫瘍，その他の卵巣腫瘍<br>　Ⅵ．腎腫瘍ならびに腫瘍類似病変<br>　　1　小児囊胞性腎腫<br>　　2　腎芽腫および造腎組織遺残<br>　　3　MiT 転座を伴う腎細胞癌<br>　　4　後腎性腫瘍<br>　　5　間葉芽腎腫<br>　　6　腎明細胞肉腫<br>　　7　腎ラブドイド腫瘍<br>　　8　腎退形成肉腫<br>　Ⅶ．肝腫瘍ならびに腫瘍類似病変<br>　　1　肝芽腫<br>　　2　小児肝細胞癌<br>　　3　肝間葉性過誤腫<br>　　4　calcifying nested stromal-epithelial tumor<br>　　5　肝胎児性肉腫<br>　　6　肝ラブドイド腫瘍<br>　Ⅷ．膵腫瘍ならびに腫瘍類似病変<br>　　1　膵芽腫<br>　　2　膵腺房細胞癌<br>　　3　solid pseudopapillary neoplasm<br>　　4　先天性高インスリン血症<br>　Ⅸ．消化管病変<br>　　1　若年性ポリープ/ポリポーシス<br>　　2　家族性大腸腺腫症<br>　Ⅹ．内分泌腫瘍<br>　　1　篩状モルラ甲状腺癌<br>　　2　甲状腺髄様癌<br>　　3　副腎皮質腫瘍<br>　　4　下垂体芽腫<br>　Ⅺ．頭頸部腫瘍ならびに腫瘍類似病変<br>　　1　鼻腔軟骨間葉系過誤腫<br>　　2　NUT 癌<br>　　3　乳児黒色性神経外胚葉性腫瘍<br>　　4　唾液腺芽腫<br>　Ⅻ．肺腫瘍<br>　　1　先天性気管支周囲筋線維芽細胞腫<br>　　2　胸膜肺芽腫<br>　XIII． 遺伝性腫瘍症候群<br>　　1　遺伝性腫瘍/がん素因症候群<br><br>第3部　臨床との連携<br>　Ⅰ．小児腫瘍におけるグループスタディ<br>　Ⅱ．小児がんの早期診断と早期治療開始の重要性―臨床医の立場から―<br>　Ⅲ．遺伝性腫瘍への対応<br>　Ⅳ．小児がんのゲノム医療<br><br>索引</section></article>
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