瘍潰性大腸炎に大腸の癌，腺腫，およびカルチノイドを合併した1例

Ulcerative Colitis Accompanied by Carcinoma, Carcinoma in Adnoma, Adenomas and Carcinoid of the Colon, Report of a Case

要旨　63歳の男性．若年時に右半結腸を切除され，残存左半結腸に潰瘍性大腸炎と直腸癌を合併した症例．注腸造影にて潰瘍性大腸炎，その後，内視鏡および生検にて直腸癌の合併と診断された．組織学的に慢性活動期の潰瘍性大腸炎，直腸のびまん浸潤型の印環細胞癌，直腸，下行結腸の腺腫，腺腫内癌およびdysplastic epitheliumそして下部直腸のカルチノイドを認めた．潰瘍性大腸炎に合併した異型上皮を診断する際には炎症に対する反応性の幼若上皮の異型の幅および炎症性腸疾患の粘膜に発生する明らかな癌もしくは腺腫の発育進展様式の特徴を熟知する必要がある．

　The patient, a 63 year-old man whose right sided colon had been resected 34 years ago. At the time, evidence of ulcerative colitis had not been noticed. When ulcerative colitis with rectal cancer was diagnosed, he underwent a descendo-sigmoido-proctectomy operation. Histological examination revealed chronic active phase of ulcerative colitis, a diffusely infiltrative type advanced signet-ring cell carcinoma in the rectum, a carcinoma in adenoma, a tubular and a tubulovillous adenoma with dysplasia manifested macroscopically by fiat plaque-like lesions in the rectum and descending colon, and a carcinoid in the distal rectum. It seems to be important to observe and define the range of atypism in immature reactive epithelium when it is in an inflammatory condition, and to accumulate more knowledge of the characteristics of overt neoplastic lesions accompanied by ulcerative colitis or other inflammatory bowel diseases previous to dyspJasia.