大きさ7mmの大腸pm癌の1例

Small Colonic Cancer 7 mm in Size Invading the Muscularis Propria, Report of a Case

要旨　患者は59歳，男性，主訴は血便，下腹部鈍痛である．X線所見では，左横行結腸に輪郭がやや不整な小さい円盤状の隆起性病変が認められ，中心に淡いバリウム斑がわずかに残存し，病変の側面像で弧状変形が認められた．内視鏡所見では，表面粘膜が粗黒糙で発赤し，中心にわずかな陥凹を伴った扁平隆起性病変が認められた．切除標本の肉眼所見では，大きさ7mm，円形の扁平病変で表面は赤色調のⅡa＋Ⅱc様病変であった．病理組織像では，粘膜下層の線維増生と固有筋層の肥厚が認められ，癌は粘膜筋板を越えて粘膜下層に浸潤し，更に粘膜下層から固有筋層にかけて散在性に浸潤していた．組織型は高分化腺癌でly₁，v₀，n₀であった．

　A 56-year-old man admitted to our hospital with chief complaints of bloody stool and lower abdominal pain. Barium enema examination disclosed a small, oval and irregularly-shaped flat but elevated lesion in the transverse colon. Frontal view of barium enema study showed a small barium spot in its center, and lateral view disclosed an arch-shaped deformity. Colonoscopic examination showed a erythematous flat but elevated lesion with a small and shallow central depression. The resected specimen contained a reddish and round-shaped flat but elevated lesion with a shallow central depression, 7×7 mm in size. Histological examination disclosed well differentiated tubular adenocarcinoma. Cancer cells invaded scatteringly into the propria muscularis accompanied by fibrosis in the submucosal layer. There was marked focal hypertrophy of the propria muscularis. No metastatic lesion was detected in the resected lymph nodes.