Stomach and Intestine(Tokyo) Volume 54, Issue 7 (June 2019)

Elevated Lesions of Mucosal Prolapse Syndrome Observed Using Magnifying Endoscopy, Report of a Case Kumi Ogihara 1 , Ken Ohnita 2 , Saburo Shikuwa 3 , Yuji Maruyama 4 , Eiichiro Fukuda 5 , Naoyuki Yamaguchi 1 , Masaaki Nonoshita 6 , Masachika Iseki 7 , Daisuke Niino 8 , Kazuhiko Nakao 1 1Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan 2Department of Gastroenterology, Inoue Hospital, Nagasaki, Japan 3Department of Gastroenterology, Nagasakikita Tokushukai Hospital, Nagasaki, Japan 4Department of Internal Medicine, Aasakura Medical Association Hospital, Asakura, Japan 5Fukuda Naika Ichouka, Sasebo, Japan 6Department of Radiology, Sasebo Kyosai Hospital, Sasebo, Japan 7Department of Pathology, Sasebo Kyosai Hospital, Sasebo, Japan 8Nagasaki Educational and Diagnostic Center of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan Keyword: 直腸粘膜脱症候群 , fibromuscular obliteration , LST , 拡大内視鏡所見 pp.1063-1069
Published Date 2019/6/25
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 A 40-year-old male without any significant medical history visited the hospital for colon cancer screening. The patient had no gastrointestinal symptoms, such as diarrhea, constipation, bloody stool, or abdominal pain. Physical examination and clinical laboratory evaluations resulted in no significant findings. Colonoscopy revealed a flat, elevated lesion in the rectum. The lesion was red in color and appeared to be a tumor spreading laterally. Dilated, round, and partially linear pits were observed in the lesion using magnifying endoscopy with crystal violet staining. The pits gradually resolved to a normal appearance at the margins of the lesion.

 Biopsy examination showed no signs of malignancy, and fibromuscular obliteration was observed in the lamina propria. These findings are consistent with MPS(mucosal prolapse syndrome). This patient did not require treatment because he was asymptomatic.

 MPS is a benign disease mainly caused by the habit of straining during bowel movements and rectal mucosal prolapse. It is categorized into three subtypes:flat, ulcerative, and polypoid. It is histologically characterized by fibromuscular obliteration of the lamina propria. This condition is relatively common but presents with various patterns. Importantly, MPS can be misdiagnosed as a malignant tumor. The current case was examined with magnifying endoscopy, and we were able to diagnose benign MPS instead of a malignant tumor.

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54巻7号 (2019年6月)
電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院