| 特集名 | いわゆる大腸側方発育型腫瘍(LST)とは | |
|---|---|---|
| 題名 | 第7回大腸IIc研究会優秀演題 2.Pseudo-depressed typeのLST非顆粒型の1例 | |
| 発刊年月 | 1998年 09月 | |
| 著者 | 黒田 浩平 | 秋田赤十字病院胃腸センター |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | "Laterally spreading tumor" of the large intestine | |
|---|---|---|
| Title | A case of a non-granular type of laterally spreading tumor with a pseudo-depressed area | |
| Author | Kohei Kuroda | Department of Gdstroenterology, Akita Red Cross Hospital |
| [ Summary ] | A 49-year-old man was found to be positive on a facal occult blood test in a screening check, and so consulted our hospital on March, 1997. Endoscopic examination revealed a widely flat, elevated lesion with a slightly depressed-like area (pseudo-depressed area) in the transverse colon, which we judged to be of the non-granular type of laterally spreding tumor (LST). On magnifying endoscopic observation, we recognised a type IIIL- 2 pit pattern in the outer portion, and an irregular pit pattern which we judged to be oh the type VA (amorhus) pit pattern in the inner part. The especialy pseudo-depressed area showed a non structural surface which we classified as type VN (non-structure) pit pattern. Therefore we diagnosed it as adenocarcinoma with massive submucosal invasious (depth degree was greater than sm2). We performed a partial transverse colectomy including the lymphnodes. After fixing and staining we obeserved it through a stereomicroscope and recognised the same configuration of pit patterns on a magnifying endoscope. Histological findings showed that the lesion was a moderately-diffrentiated adenocarcinoma with submucosal invasion (depth degree sm2) and didn't conflict with the pit pattern diagnosis of the magnifying endoscope. We subclassify non-granular type LSTs into the flat elevated type and the pseudo-depressed type. In our investigation, pseudo-depressed sub-type showed higher rates of submucosal invasion. This case was classified as a pseudo-depressed sub-type of non-granular LST. It should be considered to be an important classification of the non-granular type of when making decisions for treatment. |
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