Nodule-aggregating Lesions of the Colon: Radiologic and Endoscopic Diagnosis and Their Clinical Courses Tsutomu Ishikawa 1 1Department of Diagnostic Radiology, National Cancer Center Hospital Keyword: natural history , 結節集簇様大腸病変 , 色素内視鏡 , 扁平型大腸腫瘍 pp.389-398
Published Date 1992/4/25
DOI https://doi.org/10.11477/mf.1403106781
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 Purpose of this paper is to analyze cases of nodule-aggregating lesions and lesions accompanied nodule-aggregating components of the colon in National Cancer Center. The number of analyzed lesions are 63 (from 62 cases) of nodule-aggregating lesions and 10 (from 10 cases) of lesions accompanied nodule-aggregating components which are designated as lesions which contain nodule-aggregating lesions. The average age of these cases was 61.9 year-old. Male to female ratio was about 3 to 2. The typical findings of nodule-aggregating lesions in x-ray and endoscopic examination is that lesions are dish-like shaped with coalescence of various sized nodules (1-7 mm in size) on the surface and the height is very low compared to their extent. The most common result of the specimens from biopsy was adenoma: 26 out of 63 cases were villous tubular adenoma,17 cases were tubular villous adenoma. The specimens from 25 cases of surgical resection revealed 16 cases of adenoma,8 cases of cancer in adenoma and only 1 case of cancer invading submucosal layer (sm). These results suggest that exces sive surgical treatment should be avoided. On the contrary,9 out of 10 cases of lesions accompanied nodule-aggregating components had cancer invading sm or pm on the elevated and/or depressed area.

 We followed 7 cases of nodule-aggregating lesions and found they tend to develop slowly. Initial picture of nodule-aggregating lesions is coalescence of nodules, several mm in size. They seem to increase number and size of nodules but shape of them remains the same. There were concomitant and/or successively developed 15 cases of cancer of the colon and 13 cases of cancer of the other organs (stomach 15 cases, breast 5 cases, thyroid 5 cases and skin, ovary, lung, and esophagus 1 case respectively). Two cases of cancer family syndrome were also found in those who had nodule-aggregating lesions.

Copyright © 1992, Igaku-Shoin Ltd. All rights reserved.


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