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要旨 患者は33歳,女性.下腹部痛,粘血便を主訴に受診.大腸内視鏡検査で,S状結腸に潰瘍を伴う狭窄を認めた.潰瘍辺縁の発赤調粘膜を除き,上皮性悪性腫瘍を示唆する所見を認めなかった.形態からはびまん浸潤型大腸癌が疑われ,生検で低分化腺癌と診断された.病理組織学的には,間質反応を伴った直接浸潤と著明なリンパ管侵襲を認め,潰瘍よりも広範囲に癌が浸潤していた.組織型は低~中分化腺癌から成り立っていた.
A 33-year old woman visited the clinic because of lower abdominal pain. Colonoscopy revealed stricture of the sigmoid colon with an open ulcer. Although, we couldn't detect definite findings of malignancy in this lesion, we found reddish mucosa at the edge of the ulcer. And then we noticed other factors, such as cobblestone-like appearance and tapering stricture, which indicated diffuse infiltrating-type colorectal cancer. The biopsy specimens showed poorly differentiated adenocarcinoma. The resected specimen revealed moderately to poorly differentiated adenocarcinoma with transmural invasion, accompanied by marked desmoplastic reaction and prominent lymphatic permeation widely spread into the colonic wall.
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