{"id":7544,"date":"2021-08-13T14:28:54","date_gmt":"2021-08-13T05:28:54","guid":{"rendered":"http:\/\/www.hs-kyoto.net\/?page_id=7544"},"modified":"2021-08-18T06:56:34","modified_gmt":"2021-08-17T21:56:34","slug":"%e5%91%bc%e5%90%b8%e5%99%a8%e3%81%ae%e7%99%ba%e7%94%9f","status":"publish","type":"page","link":"http:\/\/pathology.hs.med.kyoto-u.ac.jp\/?page_id=7544","title":{"rendered":"\u547c\u5438\u5668\u306e\u5f62\u6210"},"content":{"rendered":"<h4>\u547c\u5438\u5668\u7cfb\u5f62\u6210\u306e\u306f\u3058\u307e\u308a(\u80ba\u82bd\u306e\u5f62\u6210)<\/h4>\n<p><a href=\"http:\/\/www.hs-kyoto.net\/?attachment_id=7953\" rel=\"attachment wp-att-7953\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-7953\" src=\"http:\/\/www.hs-kyoto.net\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-17-16.48.09-400x201.png\" alt=\"\" width=\"400\" height=\"201\" srcset=\"http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-17-16.48.09-400x201.png 400w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-17-16.48.09-610x306.png 610w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-17-16.48.09-115x58.png 115w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-17-16.48.09-768x386.png 768w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-17-16.48.09-150x75.png 150w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-17-16.48.09.png 868w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/a>\u767a\u751f\u7d044\u9031(Carnegie stage[CS]12)\u3054\u308d\u3001\u524d\u8178\u306e\u5185\u80da\u8449\u304c\u8179\u5074\u3078\u81a8\u51fa\u3057\u3001\u547c\u5438\u5668\u61a9\u5ba4\u304c\u5f62\u6210\u3055\u308c\u308b<sup>1,2<\/sup>(\u56f3\uff11)\u3002\u547c\u5438\u5668\u61a9\u5ba4\u306f\u5de6\u53f3\u306b\u5206\u5c90\u3057\u3001\u6c17\u7ba1\u306b\u5206\u5316\u3059\u308b\u5e79\u90e8\u5206\u3068\u3001\u80ba\u306e\u539f\u57fa\u3067\u3042\u308b\u4e00\u6b21\u6c17\u7ba1\u652f\u82bd\uff08\u80ba\u82bd\uff09\u3092\u5f62\u6210\u3059\u308b<sup>3<\/sup>\u3002<\/p>\n<h4>\u6c17\u7ba1\u652f\u306e\u767a\u751f<\/h4>\n<p><a href=\"http:\/\/www.hs-kyoto.net\/?attachment_id=7695\" rel=\"attachment wp-att-7695\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-7695\" src=\"http:\/\/www.hs-kyoto.net\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.12.13-400x261.png\" alt=\"\" width=\"400\" height=\"261\" srcset=\"http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.12.13-400x261.png 400w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.12.13-610x398.png 610w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.12.13-115x75.png 115w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.12.13-768x501.png 768w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.12.13-150x98.png 150w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.12.13.png 988w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/a>1) \u30d2\u30c8\u306e\u80ba\u306e\u767a\u751f\u6bb5\u968e\u306f5\u3064\u3067\u3042\u308a\u80ba\u82bd\u671f\u3001\u817a\u69d8\u671f\u3001\u7ba1\u72b6\u671f\u3001\u56a2\u72b6\u671f\u3001\u80ba\u80de\u671f\u306b\u5206\u985e\u3055\u308c\u308b<sup>15)<\/sup>\u3002<\/p>\n<p><a href=\"http:\/\/www.hs-kyoto.net\/?attachment_id=7691\" rel=\"attachment wp-att-7691\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-7691\" src=\"http:\/\/www.hs-kyoto.net\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.14.06-400x288.png\" alt=\"\" width=\"400\" height=\"288\" srcset=\"http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.14.06-400x288.png 400w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.14.06-610x440.png 610w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.14.06-115x83.png 115w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.14.06-768x554.png 768w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.14.06-150x108.png 150w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.14.06.png 997w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/a><\/p>\n<p>(1)\u80ba\u82bd\u671f(lung bud period)<\/p>\n<p>\u80ce\u751f\u7d044\u9031(CS12)\u306b\u547c\u5438\u5668\u7cfb\u306e\u539f\u57fa\u3067\u3042\u308b\u547c\u5438\u5668\u61a9\u5ba4(respiratory diverticulum)\u304c\u524d\u8178\u304b\u3089\u524d\u65b9\u306b\u767a\u751f\u3059\u308b<sup>8,19,21)<\/sup>\u3002\u61a9\u5ba4\u304c\u5c3e\u5074\u306b\u62e1\u5f35\u3059\u308b\u3068\u98df\u9053\u6c17\u7ba1\u7a1c\u304c\u767a\u751f\u3057\u3001\u524d\u8178\u304b\u3089\u5206\u96e2\u3055\u308c\u308b\u3002\u305d\u306e\u5f8c\u3001\u3053\u308c\u3089\u306e\u7a1c\u304c\u7652\u5408\u3057\u3066\u98df\u9053\u6c17\u7ba1\u4e2d\u9694\u3092\u5f62\u6210\u3057\u3001\u524d\u8178\u306f\u80cc\u5074\u306e\u98df\u9053\u3068\u8179\u5074\u306e\u6c17\u7ba1\u304a\u3088\u3073\u80da\u82bd(lung bud)\u306b\u5206\u5272\u3055\u308c\u308b<sup>19)<\/sup>\u3002\u80da\u82bd\u306f\u5206\u5c90\u3057\u5de6\u53f3\u306e\u4e00\u6b21\u6c17\u7ba1\u652f\u82bd(primary bronchial bud)\u3092\u5f62\u6210\u3059\u308b<sup>13)<\/sup>\u3002\u3053\u308c\u306b\u3088\u308a\u5de6\u53f3\u306e\u80ba\u304c\u5f62\u6210\u3055\u308c\u308b\u3002\u305d\u306e\u5f8c\u518d\u3073\u5206\u5c90\u3057\u7b2c\u4e8c\u6c17\u7ba1\u652f\u82bd(secondary bronchial bud)\u304c\u5f62\u6210\u3055\u308c\u3001\u3053\u308c\u304c\u5c06\u6765\u306e\u80ba\u8449(lung lobe)\u306e\u539f\u57fa\u3068\u306a\u308b<sup>19)<\/sup>\u3002\u80ba\u8449\u306f\u53f3\u80ba3\u8449\u3001\u5de6\u80ba2\u8449\u3067\u69cb\u6210\u3055\u308c\u3001\u4e3b\u6c17\u7ba1\u652f(main bronchi)\u3068\u547c\u3070\u308c\u308b<sup>11)<\/sup>\u3002\u3055\u3089\u306b\u5206\u5c90\u3059\u308b\u3068\u80ba\u533a\u57df(bronchopulmonary segment)\u306e\u539f\u57fa\u304c\u5f62\u6210\u3055\u308c\u308b<sup>2)<\/sup>\u3002\u533a\u57df\u6c17\u7ba1\u652f\u306f\u53f3\u80ba10\u500b\u3001\u5de6\u80ba8\u500b\u3067\u69cb\u6210\u3055\u308c\u308b<sup>10,11,19)<\/sup>\u3002<\/p>\n<p>(2)\u817a\u69d8\u671f(pseudoglandular period)<\/p>\n<p>\u80ba\u533a\u57df\u304c\u3067\u304d\u305f\u5f8c\u3001\u3055\u3089\u306b\u7d0414\u56de\u5206\u5c90\u3057\u7d42\u672b\u7d30\u6c17\u7ba1\u652f(terminal bronchiole)\u3092\u5f62\u6210\u3059\u308b\u3002\u3053\u308c\u306f\u767a\u751f\u7b2c16\u9031\u9803\u307e\u3067\u306b\u884c\u308f\u308c\u308b\u3068\u3055\u308c\u3066\u3044\u308b<sup>15,19)<\/sup>\u3002<\/p>\n<p>(3)\u7ba1\u72b6\u671f(canalicular period)<\/p>\n<p>\u7d42\u672b\u7d30\u6c17\u7ba1\u652f\u304c\u305d\u308c\u305e\u308c2\u672c\u4ee5\u4e0a\u306e\u547c\u5438\u7d30\u6c17\u7ba1\u652f(respiratory bronchiole)\u306b\u5206\u5c90\u3059\u308b\u3002\u3053\u306e\u6642\u671f\u306b\u547c\u5438\u306b\u95a2\u3059\u308b\u8840\u7ba1\u304c\u767a\u751f\u3057\u59cb\u3081\u308b\u3002\u3053\u306e\u9593\u306b\u8840\u7ba1\u306f\u80ba\u306e\u4e0a\u76ae\u306b\u8fd1\u63a5\u3059\u308b\u3088\u3046\u306b\u306a\u308b\u3002\u80ba\u306e\u4e0a\u76ae\u306f\u7d30\u6c17\u7ba1\u652f\u306e\u8fd1\u4f4d\u90e8\u3067\u306f\u7dda\u6bdb\u7d30\u80de\u3084\u5206\u6ccc\u7d30\u80de\u3001\u795e\u7d4c\u5185\u5206\u6ccc\u7d30\u80de\u306b\u5206\u5316\u3057\u3001\u9060\u4f4d\u90e8\u3067\u306f\u2161\u578b\u80ba\u80de\u4e0a\u76ae\u7d30\u80de(alveolar epithelial cell, type \u2161)\u3068\u2160\u578b\u80ba\u80de\u4e0a\u76ae\u7d30\u80de(alveolar epithelial cell, type \u2160)\u306e\u524d\u99c6\u7d30\u80de\u304c\u5206\u5316\u3057\u59cb\u3081\u308b<sup>19)<\/sup>\u3002\u3053\u308c\u306f\u767a\u751f\u7b2c27\u9031\u9803\u307e\u3067\u306b\u884c\u308f\u308c\u308b<sup>15)<\/sup>\u3002<\/p>\n<p>(4)\u56a2\u72b6\u671f(saccular period)<\/p>\n<p>\u547c\u5438\u7d30\u6c17\u7ba1\u652f\u306f\u3055\u3089\u306b\u5206\u5c90\u3057\u3001\u7d42\u672b\u56a2(terminal sac)\u3092\u5f62\u6210\u3059\u308b<sup>13)<\/sup>\u3002\u7d42\u672b\u56a2\u306f\u6bdb\u7d30\u8840\u7ba1\u3068\u6bdb\u7d30\u30ea\u30f3\u30d1\u7ba1\u3092\u542b\u3093\u3067\u304a\u308a\u3001\u3053\u306e\u6642\u671f\u306b\u547c\u5438\u7d30\u6c17\u7ba1\u652f\u306e\u7acb\u65b9\u4e0a\u76ae\u7d30\u80de\u306e\u4e00\u90e8\u304c\u6241\u5e73\u4e0a\u76ae\u7d30\u80de\u306b\u306a\u308a\u547c\u5438\u3067\u304d\u308b\u3088\u3046\u306b\u306a\u308b\u3002\u7d42\u672b\u56a2\u306f\u80ce\u751f\u671f\u306e\u6700\u5f8c\u306e2\u30ab\u6708\u4e2d\u3068\u751f\u5f8c\u306e\u6570\u5e74\u9593\u306b\u5897\u52a0\u3059\u308b<sup>20)<\/sup>\u3002<\/p>\n<p>(5)\u80ba\u80de\u671f(alveolar period)<\/p>\n<p>\u767a\u751f\u7d0436\u9031\u9803\u304b\u3089\u80ba\u80de\u304c\u6210\u719f\u3057\u3001\u65b0\u3057\u3044\u80ba\u80de\u306e\u5f62\u6210\u306f\u5c11\u306a\u304f\u3068\u3082\u751f\u5f8c\u3001\u6700\u521d\u306e\u6570\u5e74\u9593\u306f\u7d9a\u304f<sup>15,16)<\/sup>\u3002<a href=\"http:\/\/www.hs-kyoto.net\/?attachment_id=7697\" rel=\"attachment wp-att-7697\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-7697\" src=\"http:\/\/www.hs-kyoto.net\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.14.25-400x262.png\" alt=\"\" width=\"400\" height=\"262\" srcset=\"http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.14.25-400x262.png 400w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.14.25-610x399.png 610w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.14.25-115x75.png 115w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.14.25-768x503.png 768w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.14.25-150x98.png 150w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.14.25.png 993w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/a><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-7693\" src=\"http:\/\/www.hs-kyoto.net\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.11.53-400x265.png\" alt=\"\" width=\"400\" height=\"265\" srcset=\"http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.11.53-400x265.png 400w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.11.53-610x405.png 610w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.11.53-115x76.png 115w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.11.53-768x509.png 768w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.11.53-150x99.png 150w, http:\/\/pathology.hs.med.kyoto-u.ac.jp\/wp-content\/uploads\/\u30b9\u30af\u30ea\u30fc\u30f3\u30b7\u30e7\u30c3\u30c8-2021-08-16-10.11.53.png 974w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u547c\u5438\u5668\u7cfb\u5f62\u6210\u306e\u306f\u3058\u307e\u308a(\u80ba\u82bd\u306e\u5f62\u6210) \u767a\u751f\u7d044\u9031(Carnegie stage[CS]12)\u3054\u308d\u3001\u524d\u8178\u306e\u5185\u80da\u8449\u304c\u8179\u5074\u3078\u81a8\u51fa\u3057\u3001\u547c\u5438\u5668\u61a9\u5ba4\u304c\u5f62\u6210\u3055\u308c\u308b1,2(\u56f3\uff11)\u3002\u547c\u5438\u5668\u61a9\u5ba4\u306f\u5de6\u53f3\u306b\u5206\u5c90\u3057\u3001\u6c17\u7ba1\u306b\u5206\u5316\u3059\u308b\u5e79\u90e8\u5206\u3068\u3001\u80ba\u306e\u539f 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