| Series | ||
|---|---|---|
| Title | Case of 10 mm sized submucosal tumor-like lesion in sigmoid colon | |
| Publish Date | 2016/03 | |
| Author | Hanako Shishido | 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 | Tetsuya Mikogami | Division of Pathology, Showa University Northern Yokohama Hospital, |
| [ Summary ] | A female in her 40's was indicated for close examination. A 10 mm sized lesion resembling a submucosal tumor was observed in sigmoid colon. With dye spraying, a depressed lesion could be observed on the top of the lesion. However, it was primarily surrounded by normal mucosa. In a broad sense, it could be diagnosed as 0-Is +IIc. The depressed portion of the lesion exhibited an irregular pattern through narrow-band imaging. With magnifying endoscopy after crystal violet staining, it exhibited a depressed portion with a VI high-grade pit pattern. Using endocytoscopy (EC) after methylene blue in addition to crystal violet staining, the depressed portion revealed EC3a in EC classification. EC3a is a classification defined as images of irregular and rough lumens and a large number of roundish nuclei when strongly stained. The lesion was diagnosed as advanced cancer. In addition, in the anal side of the sigmoid colon, there was another lesion which was diagnosed as invasive cancer. The two lesions were subjected to laparoscopic-assisted surgery at the same time. Histological examination revealed a 10×10 mm type 0-Is+IIc, adenocarcinoma(tub1>tub2), pT3(v)-MP, med, INFa, ly0, v1(VB), pN3(9/27). Histological examination of the anal side lesion revealed a 13×10 mm, type 0-IIa+IIc, adenocarcinoma(tub2), pT1b, sm3(SM 6,000μm), med, INFa, ly0, v1(VB). Submucosal tumor like colorectal carcinomas are very rare. In such cases, it is very important to observe in detail by using magnifying endoscopy in relation to histological findings. |
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