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Diffusely Infiltrative Carcinoma of the Ascending Colon, Report of a Case Toshiyuki Matsui 1 , Mitsuo Iida , Masaharu Takesue 2 , Koji Yamaguchi 3 , Akinori Iwashita 4 1The Second Department of Internal Medicine, Faculty of Medicine, Kyushu University 2Kimura Hospital 3The Second Department of Pathology, Faculty of Medicine, Kyushu University 4Section of Pathology, Matsuyama Red Cross Hospital pp.655-661
Published Date 1988/6/25
DOI https://doi.org/10.11477/mf.1403108198
  • Abstract
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 We present a case of diffusely infiltrating type of colonic carcinoma. The patient was a 65-year-old woman complaining of upper abdominal pain. Barium enema examination demonstrated an irregularly demarcated narrowing and shortening of the cecum and the ascending colon (Figs. 1 and 2). Endoscopically, mucosal fold convergencies were observed in the transverse colon (Figs. 4 and 5). At operation, peritoneal dissemination was found but a right hemicolectomy was performed. Macroscopically, the resected specimen contained an annular narrowing with prominent thickening of the wall In the ascending colon a Ⅱa + Ⅱc-like lesion measuring 1.2×1.2 cm was observed (Fig. 6). Histologically, this polypoid lesion was well differentiated adenocarcinoma with gradual transition to poorly differentiated adenocarcinoma in the surrounding area (Fig. 7). Thus, it was strongly suggested that this polypoid lesion was the primary lesion. In other parts, there was a massive and scirrhous infiltration of poorly differentiated adenocarcinoma with marked lymphatic permeation (Fig. 7).

 Diffusely infiltrative carcinoma of the colon is a rare disorder, especially in the right side of the colon.

 Radiographically, this must be differentiated from ischemic colitis or Crohn's disease.


Copyright © 1988, 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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