| Series | ||
|---|---|---|
| Title | Case of massively invasive submucosal colorectal cancer : type IIa + IIc | |
| Publish Date | 2014/09 | |
| Author | Tomonari Cho | Department of Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Masashi Misawa | 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 70 year-old man underwent a total colonoscopy. The colonoscopy revealed a type IIa + IIc lesion in the lower rectum. The depressed portion of the lesion showed a sparse pattern through narrow-band imaging. Magnifying endoscopy using crystal violet staining, the exhibited a depressed portion with both Kudo's VN pit patterns and VI pit patterns. Employing endocytoscopy (EC) using methylene blue in addition to crystal violet, the depressed porion which showed Kudo's VN pit patterns magnifying endoscopy revealed EC3b in the EC classification. EC3b is a classification defined as images of unclear gland formation and agglomeration of distorted nuclei. In the present case, we also detected fine granular cells in the EC3b area, which might reflect exposure due to desmoplastic reaction (DR). The lesion was diagnosed as massively invasive submucosal cancer. We removed the lesion with endoscopic mucosal resection because the patient rejected a surgical procedure. Pathological diagnosis of the rectal specimen revealed adenocarcinoma (tub2), sm2, pSM1,625μm, ly0 (D2-40), v0 (VB), budding Grade2, pHM0, pVM0. EC imaging may be useful for in vivo histopathological prediction of submucosal cancer. |
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