雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

Multiple Carcinomas of Colon and Rectum Complicating Ulcerative Colitis, Report of a Case Y. Tsujinaka 1 1The Second Department of Surgery, Yokohama City University, School of Medicine pp.1015-1020
Published Date 1982/9/25
DOI https://doi.org/10.11477/mf.1403108818
  • Abstract
  • Look Inside

 A 29-year-old woman was admitted to Yokohama National Hospital in 1976 with a complaint of frequent mucobloody stool for the past one year. Barium enema studies revealed typical findings of ulcerative colitis. Prednisolone and salicylazosulfapyridine were administered under the diagnosis of active total colitis. During five years after initial attack she passed on her clinical course with remission and relapsing of symptoms. In April 1980, she was admitted to our hospital for operative therapy of colitis because of medical intractability.

 On admission severe anemia, left lower abdominal pain and perianal abscess were noted. Rectal biopsy showed epithelial dysplasia with marked small round cell infiltration in the lamina propria mucosa. Total proctocolectomy was done under the diagnosis of toxic megacolon on 20 th day of admission.

 Operative specimen revealed atrophic flat mucosa with two superficial ulcerative lesions at the cecum to the ascending colon, five polypoid neoplasms at the transverse colon, scirrhous neoplasm at the splenic flexure and six polypoid neoplasms mixed with villous overgrowth of mucosa at the descending colon to the rectum. Microscopic examination disclosed signet-ring cell carcinoma with marked vascular permeation in the scirrhous neoplasm and various type of invasive adenocarcinomas in all polypoid neoplasms and few foci of villous mucosa. These invasive carcinomas were surrounded by extensive or patchy lesions of various degree of epithelial dysplasia suggestive of precancerous change and intramucosal carcinomas. The epithelial dysplasia in the villous mucosa was characterized by histological transition from the flat colitic mucosa where cellular atypism had progressed downward from the upper part of tubules. The remaining mucosa showed atrophic colitis with Paneth cell metaplasia and fibrosis of submucosa.

 This case is a typical and rare example of multiple carcinomas and epithelial dysplasia based upon ulcerative colitis.


Copyright © 1982, Igaku-Shoin Ltd. All rights reserved.

基本情報

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

関連文献

もっと見る

文献を共有