INTESTINE Vol.22 No.5(10-3)

Theme Molecular biology of colorectal tumors
Title Case of cancer in TSA diagnosed by magnifying endoscopy and analyzed by molecular biology
Publish Date 2018/09
Author Toshiyuki Kubo Department of Gastroenterology and Hepatology, / Sapporo Shirakaba-dai Hospital
Author Hiro-o Yamano Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine
Author Eiichiro Yamamoto Department of Molecular Biology, Sapporo Medical University School of Medicine
Author Kei Mitsuhashi Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine
Author Hiromu Suzuki Department of Molecular Biology, Sapporo Medical University School of Medicine
Author Tadashi Hasegawa Department of Clinical Pathology, Sapporo Medical University School of Medicine
Author Makoto Eizuka Department of Molecular Diagnostic Pathology, Iwate Medical University
Author Tamotsu Sugai Department of Molecular Diagnostic Pathology, Iwate Medical University
Author Hiroshi Nakase Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine
[ Summary ] A man in his 60s was admitted to our hospital for a rectal lesion. Colonoscopy revealed an approximately 20-mm-sized, red, sessile lesion in the rectosigmoid colon. Under magnifying endoscopy using crystal violet staining, the villous part showed a serrated type Ⅳb+serrated type ⅣV pit pattern, and the oral elevated part showed a small and irregular pit pattern. We histologically diagnosed this lesion as cancer in the TSA. Genetic analysis was performed on the TSA and cancer parts, which were both BRAF mutation negative, KRAS mutation positive, and TP53 negative, with low CIMP, unmethylated MLH1, and methylated SMOC1. Cancerous cases involving the TSA are relatively rare, and this case was reported with literature considerations.
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