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Depressed-type Early Colon Carcinoma Presenting Inverted Growth Pattern, Report of a Case Koji Koinuma 1 , Kazutomo Togashi 1 , Fumio Konishi 2 1Department of Surgery, Jichi Medical School 2Department of Surgery, Omiya Medical Center of Jichi Medical School Keyword: 大腸sm癌 , ピットパターン , 内視鏡的粘膜切除 , EMR pp.356-360
Published Date 2004/3/25
DOI https://doi.org/10.11477/mf.1403100451
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 A 51-year-old man underwent colonoscopy for further examination for positive fecal occult blood. A IIa+IIc type lesion measuring 10 mm in diameter was detected in the sigmoid colon. Although there was a deep central depression, other findings of submucosal invasion were not observed. Under magnifying colonoscopy, the surface of both the depressed area and the marginal elevated lesion showed IIIL or IIIS pit patterns. VI pit pattern was not observed except in the area of the previous biopsy. VN pit pattern was not observed. We considered that the lesion was limited to the mucosa without invasion of the submucosa, and endoscopic mucosal resection was successfully carried out. The lesion was histologically diagnosed as a well-differentiated adenocarcinoma associated with adenomatous glands. The center of the tumor deviated toward the submucosa, but the lamina propria of the mucosa was present in the area deviating into the submucosa. Fragments of muscularis mucosae were observed around the deep margin of the lesion, although some parts of them were unclear. There was no desmoplastic reaction. These findings suggested that this lesion showed an endophytic and expansive growth of the musocal component into the submucosa. We diagnosed this lesion as colorectal carcinoma with minute submucosal invasion, but we consider that, basically, it had biological behavior similar to that of a mucosal carcinoma.

 1) Department of Surgery, Jichi Medical School, Tochigi, Japan

 2) Department of Surgery, Omiya Medical Center of Jichi Medical School, Saitama, 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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