Well Differentiated Carcinoma Presenting Interesting Configuration, Report of a Case Takahiro Horimatsu 1 , Takashi Kojima 1 , Atsushi Katagiri 1 , Hiroaki Ikematsu 1 , Kuang-I Fu 2 , Satoshi Fujii 3 , Yasushi Sano 1,4 1Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan 2Department of Radiology, Dokkyo Medical University, Tochigi, Japan 3Division of Pathology, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Japan 4Gastrointestinal Center, Sano Hospital, Kobe, Japan Keyword: 大腸癌 , pit pattern , invasive pattern , inverted growth pp.1529-1535
Published Date 2007/9/25
DOI https://doi.org/10.11477/mf.1403101200
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 The patient was a 60-year-old male. Endoscopic findings showed a Type IIa+IIc lesion measuring 15 mm in the ascending colon. The hole at the center of the depression area was similar to an inverted hyperplastic polyp, but magnifying colonoscopy showed mainly Type IIIL, IIIs pit pattern and highly irregular VI pit pattern whose demarcated area was not detected, so we defined it as a non-invasive pattern, and diagnosed it as a lesion limited to the submucosal and slightly invasive(below 1,000μm). We performed endoscopic mucosal resection. Histological examination of the resected specimens showed a well-differentiated adenocarcinoma with a gland showing bouton-like expansion, and confirmed that the invasion depth extended to the submucosal layer. Finally pathological diagnosis showed Type IIa+IIc, 15 mm, tub1, SM2(2,500μm), ly0, v0. Later we carried out a hemi-colectomy, but neither residual tumor nor lymph node metastasis was observed.

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