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Ulcerative Colitis Complicated with two Colonic Carcinomas and Precarcinomatous Lesions, an Autopsy Case T. Fujimori 1 , M. Miura 1 , Y. Tonariya 2 , T. Tomita 3 , K. Nagasako 4 1Dept. of Pathology, Saitama Medicine School 2Dept. of Radiology, Saitama Medicine School 3Dept. of Int. Med., Saitama Medicine School 4Institute of Gastroenterology, Tokyo Women's Medical Collage pp.323-330
Published Date 1980/3/25
DOI https://doi.org/10.11477/mf.1403106773
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 This report is an autopsy case (a 48 year-old man) of longstanding ulcerative colitis (about 15 years) with two colonic invasive carcinomas and five patchy lesions of severe atypical epithelia. The distributions of the carcinomas and the atypical colonic epithelia classified in three gradings were examined. The relationship between the carcinomas and atypical epithelia is discussed. Ulcerative colitis involving the rectum up to the terminal ileum was complicated with two carcinomas. One was an ulcerated type in the ileocecum, up to 9cm in the greatest dimension, and was microscopically proved to be poorly differentiated adenocarcinoma infiltratively proliferated in the colonic wall to the ornentum. The other was an elevated type in the proximal descending colon, up to 3.5 cm in the greatest dimension. It was microscopically well differentiated adenocarcinoma infiltrating the serosa. The atypical epithelia were extensively distributed and involved the mucosa away from the carcinomas as well as that in the immediate vicinity of them. Each of five patchy lesions of severe atypical epithelia was situated in the ileocecum, ascending colon, proximal and distal transverse colon and proximal descending colon, respectively. Macroscopic appearances of the atypical epithelia were velvety, villous, fine and rough granular and polypoicl. It was difiicult to distinguish severe atypical epithelia from mild or moderate one.

 Microscopically the atypical epithelia showed adenoInatous change, basal cell change and regenerated mucosal epithelium-like change, each of which had some relation to the severe atypical epithelia and it was difficult to differentiate the portion of the lesion from carcinoma in situ. In this case, some intimate relation between the carcinoma and the atypical epithelium was suspected. It is probably valid that the severe atypical epithelium may be considered precarcinomatous, but it was not evident that mild and moderate atypical epithelia may become severe type, though there could be such possibility. Successive colonoscopic and histological examination of ulcerative colitis will reveal true precarcinomatous lesions more exactly.


Copyright © 1980, 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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