Dome-type carcinoma of the colon; a rare variant of adenocarcinoma resembling a submucosal tumor: a case report.
Dome-type carcinoma of the colon; a rare variant of adenocarcinoma resembling a submucosal tumor: a case report.
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DOI：
10.1186/1471-230x-12-21
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发表时间：
2012-03-08
影响因子：
2.4
通讯作者：
Akasu T
中科院分区：
文献类型：
--
作者：
Yamada M;Sekine S;Matsuda T;Yoshida M;Taniguchi H;Kushima R;Sakamoto T;Nakajima T;Saito Y;Akasu T
隆起型癌（DC）是结直肠腺癌的一种独特亚型，文献中报道的病例不足10例。先前报道的大多数病例为早期病变，且迄今为止尚未有内镜观察的相关描述。在此我们报道一例侵犯浆膜下层的隆起型癌病例，包括内镜检查结果。
一名77岁男性经结肠镜检查发现横结肠有一高度隆起性病变。该肿瘤看起来类似于黏膜下肿瘤（SMT），然而，在肿瘤顶部观察到界限分明的红色不规则黏膜区域，无糜烂或溃疡。进行了腹腔镜辅助右半结肠切除术，病理检查显示肿瘤边界清晰，侵犯浆膜下层。肿瘤为高分化腺癌，伴有密集的淋巴细胞浸润，呈膨胀性生长。覆盖的黏膜层显示为高级别上皮内瘤变。
本病例被诊断为侵犯浆膜下层的结肠隆起型癌。由于黏膜上皮内瘤变在隆起型癌中较为常见，检测到上皮内瘤变对于区分隆起型癌和黏膜下肿瘤至关重要。
Dome-type carcinoma (DC) is a distinct variant of colorectal adenocarcinoma and less than 10 cases have been described in the literature. Most of the previously reported cases were early lesions and no endoscopic observations have been described so far. We herein report a case of a DC invading the subserosal layer, including endoscopic findings. A highly elevated lesion in the transverse colon was diagnosed by colonoscopy in a 77-year-old man. The tumor appeared to be similar to a submucosal tumor (SMT), however, a demarcated area of reddish and irregular mucosa was observed at the top of the tumor. There were no erosions or ulcers. Laparoscopic-assisted right hemicolectomy was performed and pathological examination revealed a well-circumscribed tumor invading the subserosal layer. The tumor was a well-differentiated adenocarcinoma associated with a dense lymphocytic infiltration and showed expansive growth. The overlying mucosal layer showed high-grade dysplasia. The present lesion was diagnosed as a DC of the colon invading the subserosal layer. Because the association of mucosal dysplasia is common in DCs, the detection of dysplastic epithelium would be important to discriminate DCs from SMTs.