腸結核に合併した早期大腸癌の1例

Early Colon Cancer Associated with Colonic Tuberculosis, Report of a Case

要旨　患者は65歳，女性．腹痛を主訴に来院．注腸X線，コロノスコピーで腸結核と上行結腸近位部の大腸癌と診断され右半結腸切除術を受けた．切除標本において癌は結核瘢痕組織内にあり，深達度mでⅡa＋Ⅱbの形態を示した．また，癌周囲とそれ以外の結核病巣内に，平坦で中等度異型を示す腺腫，いわゆる平坦腺腫（Ⅱb adenoma）が7か所認められた．これらのことは，潰瘍性大腸炎におけるcolitic cancerとの対比により，腸結核病巣を母地に発生した大腸癌を示唆するものである．

　A 65-year-old woman was admitted to our hospital because of abdominal pain. Barium enema and colonoscopic examination showed tuberculosis of the ascending colon and early cancer inside of it. Right hemicolectomy was performed. The surgical specimen showed mucosal cancer and seven lesions of flat adenoma in the tuberculous lesion. These findings are similar to those seen in the cases of colon cancer associated with ulcerative colitis. It was speculated that the colon cancer had developed on top of the colonic tuberculosis.