Stomach and Intestine(Tokyo) Volume 47, Issue 2 (February 2012)

Protruded Types of Early Sigmoid Colon Carcinoma whose Invasion Depth was Impossible to Diagnose Using Magnifying Endoscopy Observation, Report of a Case Taku Harada 1 , Hiro-o Yamano 1 , Kenjiro Yoshikawa 1 , Tomoaki Kimura 1 , Ryo Takagi 1 , Taro Abe 1 , Koujiro Tokutake 1 , Masayo Okunomiya 1 , Michiko Nakaoka 1 , Ryo Suzuki 1 , Kentaro Sato 1 , Tamotsu Sugai 2 1Department of Gastroenterology, Akita Red Cross Hospital, Akita, Japan 2Division of Diagnostic Molecular Pathology, Department of Pathology, Iwate Medical University, Morioka, Japan Keyword: 隆起型早期大腸癌 , 深達度診断 , 拡大内視鏡 , pit pattern pp.256-262
Published Date 2012/2/25
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 A male over 60 years of age was referred to our hospital for further examination because of positive occult blood in his feces. Colonoscopy revealed a protruded lesion with expansive appearance, 12mm in size, in the sigmoid colon. Magnifying colonoscopy observation showed type Vi pit pattern, but micro-surface structures and crypt orifices were preserved from the border to the top of the lesion. We diagnosed it to be a mucosal carcinoma, but didn't rule out submucosal invasive carcinoma. EMR (endoscopic submucosal resection) was performed for total biopsy. Histopathological examination revealed well differentiated adenocarcinoma(tub1) with massive submucosal invasion(5,350μm, from the surface of the tumor), ly0, v0. In the diagnosis of protruded colorectal carcinoma, magnifying endoscopy was useful for evaluating the degree of invasion. However, care should be taken in cases such as ours in which mucosal glands are preserved even though there are submucosal invasive lesions.

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47巻2号 (2012年2月)
電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院