横行結腸のⅡc型早期癌の1例

Ⅱc Type Early Cancer of the Transverse Colon, Report of a Case

要旨　患者は64歳，男性．1985年5月，S状結腸ポリープ(腺管腺腫)の内視鏡的切除術を施行．ポリペクトミー後の経過観察のため同年12月大腸ファイバースコープを行ったところ，横行結腸に新たに粘膜集中を伴う発赤斑を認め，生検の組織学的診断で癌を疑った．1986年1月当院入院，横行結腸部分切除術を施行した．肉眼的に，病変は大きさ1.5×1.5cm，胃のIIc型早期癌様の発赤を呈し，病理組織学的には高分化腺癌，深達度mと診断された．大腸の陥凹型早期癌はまれな病変であり，本症例は組織発生および形態発生を検討するうえで極めて重要なものと考えられる．

　A 64-year-old man was admitted to the Saka General Hospital in May 1986 for an operation on the transverse colon. He had underwent endoscopic polypectomy of a polyp of the sigmoid colon in May 1985. Follow-up endoscopy done on December 1985 disclosed a small redness of the transverse colon, and the biopsy specimen was strongly suggestive of cancer.

　The double contrast barium enema examination revealed a small depressed lesion of the transverse colon (Fig. 1). Partial resection of the transverse colon was performed on January 22, 1986. Operative specimen showed a slightly depressed lesion with partial mucosal convergency, measuring 1.5×1.5cm in diameter (Fig. 3).

　The lesion was histologically diagnosed as well differentiated adenocarcinoma limited to the mucosal membrane, which was comparable to a Ⅱc type early cancer of the stomach (Fig. 4a, b).

　Such cases have rarely been reported, and this one provides valuable information for investigation of the growth and progression of large bowel cancer.