Underwater endoscopic mucosal resection for a sporadic adenoma located at severe longitudinal ulcer scars in ulcerative colitis.
Underwater endoscopic mucosal resection for a sporadic adenoma located at severe longitudinal ulcer scars in ulcerative colitis.
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水下内镜下粘膜切除术治疗位于溃疡性结肠炎严重纵向溃疡疤痕处的散发性腺瘤。
作者：
Takabayashi K;Kato M;Sasaki M;Iwao Y;Ogata H;Kanai T;Yahagi N.
一位52岁的女性被诊断为溃疡性结肠炎（UC），有反复发作和缓解的病史，被转介到我们医院。结肠镜检查发现横结肠有一15毫米扁平隆起病灶。放大结肠镜窄带成像（NBI）显示日本NBI专家小组分级为2A型，周围未见扁平型发育不良病变。活检标本病理结果显示p53部分表达。基于这些发现，我们怀疑是散发性腺瘤（[图1]），而不是溃疡性结肠炎相关的肿瘤。UC炎症导致明显的纵向溃疡疤痕，病变附近有内窥镜刺青疤痕（图2）。图1放大结肠镜窄带成像（NBI）显示日本NBI Expert Team分级为2A型，周围无扁平型发育不良病变。图2结肠镜检查显示在中横结肠有一个15mm的扁平升高病灶。溃疡性结肠炎炎症有明显的纵向溃疡疤痕，病变附近有内窥镜纹身疤痕。
A 52-year-old woman diagnosed with ulcerative colitis (UC) and a history of repeated flare-ups and remissions was referred to our hospital. Colonoscopy revealed a 15-mm, flat elevated lesion in the transverse colon. Magnifying colonoscopy with narrow-band imaging (NBI) showed Japan NBI Expert Team classification type 2A and no flat dysplasia lesion in the periphery. Pathological findings of the biopsy specimen revealed a partial expression of p53. Based on these findings, we suspected sporadic adenoma ([Fig. 1]) rather than ulcerative colitis-associated neoplasia. There were obvious longitudinal ulcer scars as a result of UC inflammation and an endoscopic tattooing scar adjacent to the lesion ([Fig. 2]).Zoom Image Fig. 1 Magnifying colonoscopy with narrow band imaging (NBI) showed Japan NBI Expert Team classification type 2A with no flat dysplasia lesion in the periphery. Zoom Image Fig. 2 Colonoscopy revealed a 15-mm, flat elevated lesion in the middle-transverse colon. There were obvious longitudinal ulcer scars from ulcerative colitis inflammation and an endoscopic tattooing scar adjacent to the lesion.