ⅡaⅡc Type Early Colonic Cancer with Lymph Node Metastasis, Report of a Case Shozo Okamura 1 , Toshio Asai 1 , Hatsuhiro Yamaguchi 1 1Department of Internal Medicine, Toyohashi City Hospital Keyword: 早期大腸癌 , リンパ節転移 pp.533-538
Published Date 1991/5/25
DOI https://doi.org/10.11477/mf.1403102536
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 An asymptomatic 59-year-old man visited our hospital because of anxiety about recurrence of gastric ulcer.Upper gastrointestinal examination revealed no recurrence of gastric ulcer and laboratory study no abnormality with the exception of positive immunochemical reaction for fecal occult blood.Subsequently performed barium enema examination showed a flat elevated lesion and a small polyp in the sigmoid colon.The flat elevated lesion was oval with irregular margin and had a central shallow depression.Endoscopic examination revealed that the elevated mucosa around the depressed area was normal.

 Operation was performed on November 21, 1988.The flat elevated lesion with central depression (Ⅱa+Ⅱc type)measured 15×11 mm, macroscopically.Histological diagnosis was well differentiated tubular adenocarcinoma with extensive infiltration into the submucosal layer, but not into the deeper layers.Cancer cells were confined to the central depression in the mucosal layer, and the elevated mucosa around the depressed area was free from cancer cells.Cancer infiltration was found in only one of the removed lymph nodes.

 This case was featured by positive lymph node metastasis in spite of a small early colonic cancer with invasion into the submucosa.

Copyright © 1991, Igaku-Shoin Ltd. All rights reserved.


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