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要旨 患者は46歳,女性.SLE,慢性腎不全で外来通院治療中,シャント造設目的に入院.注腸X線検査で下行結腸に約20mm大の打ち抜き状の境界明瞭な陥凹病変を認め,大腸内視鏡検査による生検でadenocarcinomaと診断,下行結腸切除術を施行した.病理組織学的に扁平上皮化生を有するsm癌と判明した.大腸癌が良性潰瘍に類似した形態をとることはまれであり,扁平上皮化生を呈した点でも貴重と思われ報告する.
We encountered a case of Submucosal invasive colon cancer which showed punched out ulcer-like appearance. A 46-year-old female patient with systemic lupus erythematosus (SLE) and chronic renal failure (CRF) was admitted to our hospital because of a hemodialysis complication. Barium enema and colonoscopy examination revealed (Fig. 1, 2) an ulcer, which was of punchedout shape and distinct, with normal surrounding mucosa in the descending colon. Histological examination of the resected specimen showed well-differentiated adenocarcinoma with squamous differentiation.
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