Diagnostic Basis and Analysis of X-ray Examination on Early Superficial Colorectal Neoplasm Jiro Watari 1 1Foundation for Detection of Early Gastric Carcinoma Keyword: 表面型大腸腫瘍 , 微小病変 , X線診断 , 内視鏡診断 , 病理割面像 pp.889-901
Published Date 1992/8/25
DOI https://doi.org/10.11477/mf.1403109949
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 We analyzed 128 lesions from 119 patients with minute superficial epithelial colonic neoplasms(smaller than 5 mm in size) on fixed specimens between February of 1990 and February of 1992. The purpose of this paper is to evaluate the specificity of x-ray diagnosis on these lesions. The lesions were classified as 78 superficial and elevated,3 superficial but flat and 47 nonelevated. The superficial depressed type can be divided into 3 subtypes: 1) slightly elevated lesion with central depression,2) depression with marginal elevation,3) absolute depression. The difference in shape and size among x-ray, endoscopic and microscopic examinations are discussed. Procedural techniques to demonstrate the lesions on x-ray examination were also discussed.

 Out of 46 lesions, only 13 depressed lesions(28.3%) were detected by routine barium enema examination. After reviewing these x-ray films, 22 lesions(47.8%) were pointed out. In 8 cases of depressed type, only prone positioned films revealed the lesions. It is not necessary to demonstrate a fine network pattern to detect centrally depressed lesions.

 Microscopic examination showed the strip biopsized specimens were usually too stretched out at fixation. Only 61.9% of the sespecimens could be analyzed, and 61.5% of the analyzed specimens were compatible with the clinical features. On microscopic examination, most early colorectal carcinomas were relatively depressed, which is quite different from type Ⅱc early gastric caner. One of the benefits of x-ray examination is to keep the permanent images of lesions which enable us to follow them afterward. If these images are of sufficient quality, we may be able to analyze them in a timely fashion in the future.

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


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