直腸カルチノイドの1例

A Case of Rectal Carcinoid

　微小な直腸膨大部癌と診断し，直腸切断術を行ない，術後の組織学的検索によって直腸カルチノイドと判明した1症例を経験したので報告する．

　患　者：63歳　男性

　主　訴：特記すべきものなし

　既往歴：33歳，虫垂切除術．40歳，赤痢・マラリア，15歳頃より痔疾に悩み現在に至っている．

　家族歴：特記するべきものなし

　現病歴：消化器病センター定期検診部の会員で，直腸指診により隆起性病変が存在することを指摘された．直腸鏡下に生検を行ない，癌を疑われ入院，手術を勧められた．

　A case of rectal carcinoid, whose histological differentiation from adenocarcinoma was very difficult, was correctly diagnosed by electronmicroscopy.

　A patient, 63 years old male, consulted our hospital for periodic health examination. He complained of no lower abdominal symptoms. Digital examination of the rectum revealed a small hard nodule. Endoscopically the tiny nodule was of yellowish cast and the overlying mucosa was almost normal. Its diameter was assumed to be about 9 mm. No ulceration and erosion were observed.

　Opetation was carried out because of the difficulty of the differentiation of carcinoid from adenocarcinoma. Silver stains were negative. Electron microscopic examination of the resected specimen revealed numerous dense particles, characteristic for carcinoid tumor. The diagnosis of carcinoid tumor was then established.