潰瘍性大腸炎に合併した直腸癌の1例

Ulcerative Colitis Accompanied with Rectal Cancer, Report of a Case

要旨　43歳，女性．31歳時より血性下痢で発症．都立駒込病院内科で治療を継続，寛解状態にあったが43歳のフォローアップの精査時に直腸隆起性病変を指摘された．大腸全摘術を施行され切除標本では大腸全体に粘膜萎縮，瘢痕を認めたが炎症細胞浸潤は軽度で寛解状態にある潰瘍性大腸炎の状態であった．主病変は粘膜下層に一部浸潤する高分化腺癌であり，それ以外にも広範に異型腺管が認められ，一部は微小粘膜内癌と診断しうるものであった．

　A 43-year-old woman had onset of ulcerative colitis with bloodly diarrhea at 31 years of age. She had been treated medicinally and her UC had been resolved, but follow-up examination revealed a protruded rectal lesion. Total colectomy was performed. The surgical specimen revealed inactive-stage ulcerative colitis with multiple scars and mucosal atrophy. The main lesion was a well differentiated adenocarcinoma inva-ding the submucosal layer. In addition atypical tubules were found widely distributed and some of them seemed to indicate ‘microcarcinoma'.