潰瘍性大腸炎と大腸癌―自験例3例の病理学的検討を中心に

Large Intestinal Carcinomas Complicating Ulcerative Colitis, Report of Three Cases

要旨　潰瘍性大腸炎と癌の合併は，欧米では多くの報告があるのに比し，本邦では遭遇する機会が比較的少ない．当教室で検索された大腸癌症例1,744例の中に確実に潰瘍性大腸炎を合併したものは3例みられた．3例とも長い臨床経過を有し病理学的に広範な潰瘍性大腸炎を伴っていた．このうち2例は癌多発例，残り1例は癌単発例であり，従来言われてきた潰瘍性大腸炎に合併する癌の病理学的特徴のうち幾つかを備えていた．3例中2例にdysplasiaに当たる上皮の変化が部分的に認められたが癌との関係を論ずるには更に症例の集積を要すると考えられる．high iron diamine染色の結果はdysplasiaにおける粘液変化が単一のものではないことを示した．

　We report herein three cases of large intestinal carcinomas complicating ulcerative colitis. All cases showed extensive ulcerative colitis. All patients had suffered from ulcerative colitis for more than ten years. The ulcerative colitis started early in life in two patients. The large intestinal carcinomas were multiple in two cases and single in the other. Some of these carcinomas revealed pathologic features somewhat different from ordinary large intestinal carcinomas: the tumors showed vinous, nodular or flat appearance. Two cases showed adenomatous atypical epithelium, a positive indication of the likelihood of dysplasia (proposed by Ridden), which was confined to small areas around the carcinomas. High iron diamine staining showed various amounts of sialomucin and sulphomucin in the dysplastic mucosa.