Type0-IIc+IIa Rectal Intramucosal Carcinoma which was Diagnosed as Type VN Pit Pattern by Magnifying Colonoscopy, Report of a Case Kin-ichi Hotta 1 , Tsuneo Oyama 1 , Akihisa Tomori 1 , Yoshinori Miyata 1 , Shuko Morita 1 1Department of Gastroenterology, Saku Central Hospital Keyword: 拡大内視鏡 , VN型pit pattern , 直腸粘膜内癌 pp.1413-1417
Published Date 2004/9/25
DOI https://doi.org/10.11477/mf.1403100573
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 A59-year old man underwent colonoscopy for surveillance after polypectomy. Conventional colonoscopy revealed a reddish depressed lesion,10mmin diameter, with flat elevation in an anal part of the upper rectum. There was a deeper depressed area in the lesion. Magnifying colonoscopy showed type VI pit pattern in the depression, and type VN pit pattern in the deeper depressed area. This pit pattern was diagnosed as “Invasive pattern” as proposed by Dr. Fujii. The lesion was diagnosed as a rectal cancer with deep submucosal invasion, and the patient underwent laparoscopic assisted high anterior resection. However, pathological diagnosis was well to moderately differentiated adenocarcinoma limited in the mucosal layer. There was neither vessel permeation nor lymph node metastasis. The VN pit pattern was due to the erosive surface of the lesion that consisted of moderately differentiated adenocarcinoma. We should recognize that a high grade cancer appears to have type VN pit pattern even if it is an intramucosal cancer.

 1) Department of Gastroenterology, Saku Central Hospital, Nagano, Japan

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