| 特集名 | 10 mm以上の表面陥凹型腫瘍 | |
|---|---|---|
| 題名 | 形態学的特徴 (3) 病理学的特徴 | |
| 発刊年月 | 2004年 05月 | |
| 著者 | 斎藤 彰一 | 東京慈恵会医科大学内視鏡科 |
| 著者 | 池上 雅博 | 東京慈恵会医科大学病理学講座 |
| 著者 | 藤原 淳 | 京都府立医科大学大学院・消化器病態制御学 |
| 著者 | 田尻 久雄 | 東京慈恵会医科大学内視鏡科 |
| 著者 | 羽野 寛 | 東京慈恵会医科大学病理学講座 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Depressed type of lesions over 10 mm in size | |
|---|---|---|
| Title | Histopathological features and differences between superficial depressed type cancer (IIc) and laterally spreading tumor (LST) | |
| Author | Shoichi Saito | Department of Endoscoy, The Jikei University School of Medicine |
| Author | Masahiro Ikegami | Department of Pathology, The Jikei University School of Medicine |
| Author | Atsushi Fujiwara | 3rd Department of Internal Medicine, Kyoto Prefectural University of Medicine |
| Author | Hisao Tajiri | Department of Endoscoy, The Jikei University School of Medicine |
| Author | Hiroshi Hano | Department of Pathology, The Jikei University School of Medicine |
| [ Summary ] | The disease entity "Laterally Spreading Tumor (LST)" was proposed to distinguish it from the small superficial type of tumor by Kudo, in 1993. We classified the superficial type of early colon cancers into two groups through endoscopic findings. One is the superficial depressed type colon cancer (so called IIc shaped cancer) (Group Type A), the other is LST, in which the growth and development of tumor cells spreads laterally (Group Type B and C). Moreover, LST type tumors were divided into two types, the flat elevated type (Type B) and the pseudo-depressed type (Type C). We investigated the histopathological differences between the type A and the type C. The growth pattern of sub-mucosal (sm) invasive cancer was classified into two types those with or without mucosal cancerous lesions. We also divided them into two groups, determined by the invasive pattern in the sub-mucosa. A total of 16 IIc type lesions (type A), 8 LST flat elevated lesions (type B) and 14 LST pseudo-depressed lesions (type C), resected surgically or endoscopically, were selected for this study. Type A (93.8%) showed a significantly higher incidence of sub-mucosal invasion than type C (71.4%). Histopathologically, the growth of neoplastic glands in type A was seen in the whole mucosal layer, in contrast, the growth of neoplastic glands in type C was only in the superficial layer of the mucosa in the edge of the tumor lesion. It was also noted that in cases of sub-mucosal invasive cancer, the invasive pattern of type A was shown to be one of massive tumor growth within the tumor (93.3%). In type C, some tumor glands invaded the sub-mucosal layer at several points in the tumor lesion (60.0%). Therefore, some differences in the pathogenesis of type A and type C, as well as type B, were clarified. |
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