INTESTINE Vol.22 No.1(13)

Series
Title Case of ascending colon cancer : pathologically and genetically interesting findings
Publish Date 2018/01
Author Yoshihito Tanaka Department of Gastroenterology, Akita Red Cross Hospital / Department of Molecular Diagnostic Pathology, Iwate Medical University
Author Hiro-o Yamano Department of Gastroenterology, Akita Red Cross Hospital / Department of Gastroenterology and Hepatology, Sapporo Medical University
Author Hiro-o Matsushita Department of Gastroenterology, Akita Red Cross Hospital
Author Makoto Eizuka Department of Molecular Diagnostic Pathology, Iwate Medical University
Author Tamotsu Sugai Department of Molecular Diagnostic Pathology, Iwate Medical University
Author Eiichiro Yamamoto Department of Gastroenterology and Hepatology, Sapporo Medical University / Department of Molecular Biology, Sapporo Medical University
Author Hiromu Suzuki Department of Molecular Biology, Sapporo Medical University
[ Summary ] A man in his 70s underwent a total colonoscopy following a positive fecal occult blood test. A laterally spreading tumor (LST) with a dimeter of 20 mm was found in the ascending colon. The major part of the tumor was white, but some section were reddish. Magnifying chromoendoscopy revealed that the white part was Type II and Type II-long pit and that the reddish parts were Type VI and Type IVB pit. Based on these results, we suspected that the adenomas derived from hyperplastic polyps developed into cancer or that this was a collision tumor. In pathological examination, we observed a proliferation of tubular ducts which did not fall into any current categories of serrated lesions. We also observed the mixture of tubular adenoma and well differentiated tubular adenocarcinoma. In addition, we observed a moderately differentiated tubular adenocarcinoma. Tumor depth of invasion was pT1a (SM 300 µm) and no vascular invasion was observed. The results of genetic analysis suggest that this is a genetically homogenous tumor. However, no findings support that this tumor developed through a serrated pathway and adenoma-carcinoma sequences were obtained.
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