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The Clinico-Pathological Features of Flat and Depressed Type of Early Colorectal Cancer Shin-ei Kudo 1 , Shunichi Hayashi 2 , Yukio Takano 1 1Department of Surgery, Akita Red Cross Hospital 2Department of Internal Medicine, Akita Red Cross Hospital pp.317-329
Published Date 1989/3/25
DOI https://doi.org/10.11477/mf.1403106417
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 Since April 1985, we observed 71 different lesions of flat and depressed type neoplatic lesions by endoscopic examination. We divided them into two different categories : early cancer (32 lesions) ; and tubular adenoma (39 lesions) .

 There were 23 lesions of non-elevated flat lesion (Ⅱb type), under 5 mm ; 7 of Ⅱb type early cancer. 14 of non-elevated depressed type (IIc type) were early type cancer, except one which was a different lesion. And all other lesions were depression-with-peripherally-elevated type (Ⅱc+Ⅱa, Ⅱa+Ⅱc).

 One characteristic effect of the visible manifestations of the flat and depressed type early cancer by endoscopic examination showed that the outside of the intes-tines can be stronger than the rising protuberance and the depressed part. Furthermore, the depressed part was emphasized by decreasing the air pressure inside of the intestines (air transformation) .

 The usual color of early cancer is a light red, but sometimes it can be seen as faded white. There was only one case in this series which was shown histologically to be early cancer. It was a case of poorly differentiated adenocarcinoma. All the others were cases of well defined adenocarcinoma. We pursued colon resection as the treatment in eight cases. However, mucosal carcinoma was treated with strip biopsy, in accord with the general practice.

 Using a dissecting microscope, we noticed the shape of tumors was circular, tubular and mixed, with a small pit pattern. Morever, it was observed that the surfaces were irregular and non-organized.


Copyright © 1989, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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