INTESTINE Vol.18 No.1(10)

Series
Title A case of early-stage colorectal cancer : a laterally spreading tumor with two components
Publish Date 2014/01
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.
back