Superficial-type Colorectal Carcinoma, Measuring below 1cm in Maximum Size: from the viewpoint of pathology Satoshi Okabe 1 , Akiyoshi Yamanaka 1 , Kagami Nagai 1 , Yoshiharu Maeda 1 , Touichirou Takizawa 1 , Morio Koike 1 1Department of Pathology, Tokyo Metropolitan Komagome Hospital Keyword: 表面型大腸上皮性腫瘍 , 扁平腺腫 , 表面型粘膜内癌 , 実体顕微鏡所見 pp.847-858
Published Date 1990/7/25
DOI https://doi.org/10.11477/mf.1403111107
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 We have compared superficial-type colorectal carcinomas with small flat adenomas of the colon and rectum with regard to macroscopic, microscopic, and stereomicroscopic characteristics. We did this reviewing our own cases of colorectal carcinoma, which were resected by operation or endoscopic surgery in the last 12 years in our hospital.

 We have examined 21 lesions of superficial-type intramucosal carcinoma, 7 lesions of submucosal invasive carcinoma, and 39 lesions of flat adenoma below 1 cm in size, respectively.

 As a result of this research, we determined that it is possible to distinguish between superficial type colorectal carcinomas with high malignant potentiality and those with low malignant potentiality.

 We can distinguish the former from the latter in the following respects.

 1) We can classify, as carcinomas with high malig-nant potentiality those lesions which show slight depression associated with redness on the mucosal surface. This phenomenon tends to show downward growth.

 2) As a result of stereomicroscopical observation, we determined that carcinomas with high malignant potentiality show superficial minute irregularly grooved structure, or irregular shape with slight depression on the mucosal surface.

 3) Histopathologically, superficial type carcinomas, which show oppressed and thin mucosal muscular layer associated with irregular ramification of carcinomatous glands in the deep portion of the mucosa, can possibly be classified as intramucosal carcinomas with high malignant potentiality.

 We have concluded that it is worthwhile noting that there are morphological similarities between Ⅱa type intramucosal carcinomas below 1 cm in size and other superficial type neoplastic lesions, which are Ⅱb, Ⅱc, Ⅱa+Ⅱc type carcinomas, and are a part of “flat adenomas”, and therefore there is a possibility that these lesions are prototypes of ordinary advanced colorectal carcinomas.

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