潰瘍性大腸炎の経過中にm癌と異型上皮を認めた1例

Two Mucosal Cancers and Six Dysplastic Lesions Associated with Ulcerative Colitis, Report of a Case

要旨　全結腸炎型の潰瘍性大腸炎の経過中に内視鏡検査，X線検査で比較的大きな平盤型病変を8つ認め，それらの中の1つが生検でGroup4の診断であったため結腸全摘術が行われた．これらの平盤型病変のX線所見は丈の低い病変であり，m癌の1病変は不揃いな結節状を呈していた．異型上皮は均一な顆粒状を呈していた．内視鏡通常観察でこれらの平盤型病変を見出すには，粘膜の光沢の変化に注意する必要がある．光沢の変化を認めた場合には色素撒布により病変は明瞭となる．m癌の1病変では発赤と不均一な結節が認められた．

　A 67-year-old female, who had had ulcerative colitis (total colitis) since the age of 61, was examined by endoscopy and barium enema because of bloody stool and diarrhea. The endoscopic examination revealed eight plaque-like lesions in the large bowel. In one of them histological examinations of the biopsy recognized Group 4. Radiological findings of plaque-like lesion were demonstrated as radiolucent lesions and endoscopic findings, using a dye-spray method, were plaque-like lesions with a nodular pattern.

　Total colectomy with ileo-rectal anastomosis was performed. The histological examination showed that two mucosal cancers of the cecum and transverse colon were well differentiated adenocarcinomas and six plaque-like lesions of the colon ascendens, transverse and descendens were dysplasia, and that colonic mucosa was in a remission stage.