著明な粘膜橋を呈したS状結腸粘液癌の1例

The Formation of Mucosal Bridge Associated with Pathological Manifestation of The Mucinous Carcinoma at the Sigmoid Colon, Report of a Case

要旨●患者は60歳代，女性．主訴は血便．大腸内視鏡検査，注腸X線造影検査にてS状結腸に大きさ40mm大の腫瘍を認めた．腫瘍の表面には著明な粘膜橋が形成され，トンネル様の腔を伴う特異な形態を呈していた．病理組織学的に癌は粘液癌の成分のみから成り，粘膜橋部分は非腫瘍粘膜に覆われていた．大腸炎症性疾患の既往や治癒経過に粘膜橋を合併した症例ではなく，粘膜橋の形成に粘液癌という癌病変の病理組織学的特異性が強く関与したと考えられる1例を経験した．画像診断における特徴を述べるとともに，粘膜橋の形成に関する考察を加え報告する．

　A 64-year-old woman was admitted to the hospital to examine bloody stool. A barium enema and colonoscopic examination revealed a 40-mm-sized type 2 advanced colon cancer of unusual shape, which was involved in the marked mucosal bridge and tunnel-like construction at the sigmoid colon. Pathologically, the cancer lesion only consisted of mucinous carcinoma, and the mucosal bridges were covered with non-neoplastic mucosa. A previous report had shown that mucosal bridges were related with colonic inflammation or their healing process. However, in the present case, we observed that the formation of the mucosal bridge was significantly associated with the pathological manifestation of the mucinous carcinoma.