Submucosal Invasive Colorectal Cancer in Serrated Adenoma Showing Granular Type of LST(laterally spreading tumor), Report of a Case Keisuke Kawasaki 1 , Hiroyuki Kobayashi 1,2 , Koichi Kurahara 1 , Yumi Oshiro 3 , Takashi Yao 4 , Ken Kominato 1 , Chiaki Koga 1 , Mao Funata 1 , Koichi Abe 1 , Kensei Otsu 1 , Ema Washio 1 , Yuji Sakai 1 , Tadahiko Fuchigami 1 1Division of Gastroenterology, Matsuyama Red Cross Hospital, Matsuyama, Japan 2Division of Gastroenterology, Fukuoka Sanno Hospital, Fukuoka, Japan 3Department of Pathology, Matsuyama Red Cross Hospital, Matsuyama, Japan 4Department of Human Pathology, Juntendo University School of Medicine, Tokyo Keyword: LST , 鋸歯状腺腫 , NBI , pit pattern pp.1885-1890
Published Date 2012/11/25
DOI https://doi.org/10.11477/mf.1403113658
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 A 55-year-old man was admitted to our institution because of a rectal lesion detected by colonoscopy carried out on further examination for positive fecal occult blood.

 Colonoscopy disclosed a flat elevated lesion with one large nodule, whose surface was granular, measuring 65mm in size, in the lower rectum. The size of the large nodule was 10mm, and was reddish in color. NBI(narrow band imaging)view showed irregular microvessel features and an avascular area in the large nodule. Magnifying endoscopy with crystal violet staining demonstrated highly irregular Vi pit pattern within the large nodule. Fern-like patterns were seen in the surrounding flat, granular area. The tentative endoscopic diagnosis of the lesion was submucosal invasive cancer. The lesion was resected surgically by super low anterior resection of the rectum. Histological examination of the resected specimen showed well-to-moderately differentiated tubular adenocarcinoma in a serrated adenoma. Depth of invasion was 6,000μm in the large nodule. We diagnosed this lesion to be an early colorectal cancer arising in a serrated adenoma.

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