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Adenoma of the Sigmoid Colon Difficult to Differentiate from Invasive Colon Cancer, Report of a Case Yayoi Oishi 1 , Toshio Hoashi 1 , Keisuke Ikeda 1 , Yuki Koga 1 , Masae Mano 2 1Department of Gastroenterology, Saiseikai Futsukaichi Hospital 2Department of Surgery, Saiseikai Futsukaichi Hospital Keyword: 弧の硬化像 , 伸展不良所見 , V型pit pp.101-106
Published Date 2004/1/25
DOI https://doi.org/10.11477/mf.1403100420
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 A 57-year-old woman was admitted for abdominal pain and vomitting. Endoscopic gastrointestinal examination revealed a long wide IIc tumor in the gastric body with signet ring cell carcinoma. Colonoscopic examination revealed an elevated lesion, about 25 mm in diameter, which seemed to have a central slightly depressed area. The fold around the tumor did not indicate rigidity of the arc in the lumen. The biopsy revealed Group 4 tumor. Barium enema was unable to show the frontal view of the tumor but pneumatic expansion of the colon revealed that the tumor was extensive. In the magnifying view with crystal violet staining, the central lesion of this tumor was shown to have an irregular pit pattern of type V. In the examination using 7.5 MHz endoscopic ultrasonography, the central lesion of the tumor was revealed to be invading the submucosa or muscularis propria. Histological diagnosis was tubulovillous adenoma with moderate and partly severe atypia. Immunohistochemically, tumor cells were shown to be partly positive for p53. This case had been mistakenly diagnosed as invasive sigmoid colon cancer because of the information provided by magnifying endoscopy or endoscopic ultrasonography.

 1) Department of Gastroenterology, Saiseikai Futsukaichi Hospital, Fukuoka, Japan

 2) Department of Surgery, Saiseikai Futsukaichi Hospital, Fukuoka, Japan


Copyright © 2004, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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