横行結腸の微小Ⅱc型早期癌の1例

Depressed (Ⅱc) Type Minute Early Cancer of the Transverse Colon, Report of a Case

要旨　患者は64歳，男性．1985年，S状結腸ポリープの内視鏡的切除を施行．その後のfollow-upのため1987年4月，大腸内視鏡検査を行ったところ，横行結腸に辺縁隆起を伴う不整形の小陥凹性病変を認め，生検で腺癌と診断された．注腸造影でも辺縁に透亮像を伴う不整形バリウム斑として描出された．同年10月，横行結腸部分切除術を施行した．切除標本では陥凹面2×2mmのⅡc病変で，組織学的には深達度smの高分化腺癌で，腺腫成分の併存は認められなかった．

　A 64-year-old man was addmitted to Kurume University Hospital for further medical evaluation and treatment of a minute depressed lesion in the transverse colon.

　He had previously undergone endoscopic polypectomy of sigmoid polyps in 1985. Follow-up endoscopy in April 1987 disclosed a small, reddish and irregular depressed lesion with surrounding elevation in the transverse colon. Biopsy specimen showed adenocarcinoma.

　Partial resection of the transverse colon was performed on October 22, 1987. Surgical specimen showed a minute and shallow depressed lesion, measuring 2 × 2 mm in size. The lesion was histologically diagnosed as well differentiated adenocarcinoma with submucosal invasion. No adenomatous component was contained. Finally, the lesion was proven to be Ⅱc type "de novo" cancer of the colon.