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Colorectal Neuroendocrine Carcinoma Arising from a Serrated Polyp, Report of a Case Hiroyuki Hatamori 1 , Shoichi Saito 1 , Yoshimasa Horie 1 , Chihiro Yasue 1 , Daisuke Ide 1 , Akiko Chino 1 , Masahiro Igarashi 1 , Hiroshi Kawachi 2 1Department of Gastroenterology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 2Department of Pathology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo Keyword: 大腸ポリープ , 鋸歯状病変 , 内分泌細胞癌 , NEC pp.1639-1646
Published Date 2020/12/25
DOI https://doi.org/10.11477/mf.1403202212
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 A 73-year-old woman with advanced transverse colon cancer was referred to our hospital for surgical management. Colonoscopy revealed another lesion in the ascending colon ; a 10-mm diameter sessile polyp with central depression was observed. Magnifying endoscopy with narrow-band imaging demonstrated an amorphous pattern with loose vessels in the area of the central depression. Chromoendoscopy showed that the area of the central depression and peripheral edge showed type VN(nonstructure)and dilated type II pit patterns, respectively. Although the endoscopic diagnosis indicated submucosal invasive cancer, an EMR(endoscopic mucosal resection)was performed because of the small size of the lesion.

 Histopathological evaluation revealed a neuroendocrine carcinoma invading the deep submucosal layer(pT1), with lymphatic and venous infiltration at the center of the lesion. The periphery of the lesion was a serrated polyp characterized by the presence of serrated adenomatous crypts with mucin-rich cytoplasm. An immunohistochemical evaluation showed that the neuroendocrine carcinoma region was strongly and diffusely positive for synaptophysin and CD56. The Ki-67 index was 80%. Subsequently, right hemicolectomy was performed, and the advanced transverse colon cancer was diagnosed as neuroendocrine carcinoma based on the histopathological evaluation.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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