Series |
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Title |
A case of early-stage colorectal cancer : a laterally spreading tumor with two components |
Author |
Chiyo Maeda |
Department of Digestive Disease Center, Showa University Northern Yokohama Hospital |
Author |
Toyoki Kudo |
Department of Digestive Disease Center, Showa University Northern Yokohama Hospital |
Author |
Shin-ei Kudo |
Department of Digestive Disease Center, Showa University Northern Yokohama Hospital |
Author |
Hideyuki Miyachi |
Department of Digestive Disease Center, Showa University Northern Yokohama Hospital |
Author |
Fumio Ishida |
Department of Digestive Disease Center, Showa University Northern Yokohama Hospital |
Author |
Shigeharu Hamatani |
Division of Pathology, Showa University Northern Yokohama Hospital |
[ Summary ] |
A 69 year-old man underwent surveillance total colonoscopy after surgery for transverse colon cancer. Colonoscopy revealed a laterally spreading tumor (LST) measuring approximately 10 mm in diameter in the upper portion of the rectum. The lesion had two components ; a flat elevation and a shallow depression. The flat elevation showed a network pattern and the depressed component showed an irregular pattern with narrow-band imaging. On magnifying endoscopy, using crystal violet staining, the flat elevation showed type IVB pit patterns and the depressed component showed type VI low-grade pit patterns. The depression was surrounded by type I pits. The lesion was diagnosed as an adenoma or intramucosal cancer, endoscopic mucosal resection was performed. Pathological examination showed that this lesion was a IIa (LST), 10×7 mm, adenocarcinoma (tub1) with adenoma, pM, HM0, VM0. Histologically, the depressed area was classified as tubular adenocarcinoma and a part of the elevation exhibited tubular adenoma. The flat elevation showed polypoid growth and the depressed component showed non-polypoid growth. This case may be important in considering patterns of colorectal cancer development/progression. |