異時性多発癌として発見された大腸早期印環細胞癌の1例

Early Signet-ring Cell Carcinoma of the Large Intestine Detected as Heterochronic Multiple Cancers, Report of a Case

要旨　症例は62歳，男性．大腸早期癌（粘膜内癌）の内視鏡的治療6年後に，経過観察目的の大腸内視鏡検査と生検にて上行結腸にIIc＋IIa型印環細胞癌を指摘された．上部消化管内視鏡検査，胸・腹部CT検査等の画像診断に異常はなく，上行結腸部分切除術が施行された．病理組織学的には最大径10mm，IIc＋IIa型signet-ring cell carcinoma with adenoma，深達度sm3，ly2，v1，Infα，n1と診断された．大腸原発早期印環細胞癌の報告例は少なく，臨床病理組織学特徴を明らかにするためには早期癌症例の集積が必要と考え報告した．

　On colonoscopy examination and biopsy carried out to observe the course of early colorectal cancer (intramucosal carcinoma) that had received endoscopic treatment six years before, a 62-year-old man was considered to have a type IIc＋IIa signet-ring cell carcinoma of the ascending colon. No abnormalities were revealed by diagnostic imaging examinations including upper gastrointestinal endoscopy,CT examination of the chest and abdomen, etc. The patient was treated by partial resection of the ascending colon. The carcinoma was histopathologically diagnosed as a 10 mm in maximum diameter, type IIc＋IIa, signet-ring cell carcinoma with adenoma, and invasiveness of sm3, ly2, v1, Infαand n1.

　There have been only a limited number of reports on primary early signet-ring cell carcinoma of the large intestine, so it was considered necessary for elucidation of clinico-histopathological characteristics to report such a case in early cancer patients.