大腸多発性化生性ポリープの3個に早期癌を認めた1症例

DOI 被引用文献3件 参考文献23件

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  • MULTIPLE METAPLASTIC POLYPS OF THE COLORECTUM CHARACTERIZED BY THREE METAPLASTIC POLYPS CONTAINING AN INVASIVE CARCINOMA AND TWO INTRAMUCOSAL CARCINOMAS: A SASE REPORT

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We report a case of multiple metaplastic polyps of the colorectum in which one polyp had an area of invasive carcinoma and two polyps had intramucosal carcinoma in the metaplastic architecture. The patient, who was a 56-year-old man without a family history of colorectal polyps and a history of previous colorectal disease, underwent colonoscopy for constipation that revealed 22 polyps dispersed over the colorectum All ofthe polyps were resected colonoscopically, 18 with a snare device and 4 with hot biopsy forceps. The diameter of the metaplastic polyps ranged from 6 to 21mm, with a mean of 11.6mm. We termed the metaplastic polyps without a neoplastic component as M-type(metaplastic type), those with a neoplastic component as Gtype(coincidental type), and neoplastic polyps without a metaplastic component as n-type(neoplastic type). In this casewhich classified into MCn-type, pathological examinations revealed that of the 22 polyps, 15were M-type, 3were C-type, and 4 were n-type. The 3 of C-type comprised one invasive and two intramucosal carcinomas. Multiple metaplastic polyps of the colorectum is such a rare condition that only 30 case reports existed in the Japanese and English literature as of Sept. 1994' of these 24(including ours) were described in detiail. We classified these 24 cases of multiple metaplastic polypsof the colorectum into 4 groups; namely M-group if all of the polyps were M-type(9 cases), the MC-group if the polyps were M and C-type(3 cases), the Mn-group if the polyps wereMand n-type (7 cases), and the MCn-group if the polyps were M, C and n-type(5 cases). We compared these four groups with ranged to average age, sex, distribution of polyps, rate of the number of polyps over 100, and diameter of the biggest polyps. Our resultindicated that the MCn-and MC-groups mast frequently had carcinoma in the metaplasticpolyps, while the Mn-group most frequently had carcinoma in the neoplastic polyps. If neoplastic components are observed on biopsy of metaplastic polyps, we should consider coincidental carcinoma in the poiyps. We faund that as risk factors of carcinoma existingin metaplastic polyps, the polyps have a wide distribution over the coloreetum, the numberof polyps is usually ovor 100, and the diameters of the biggest polyps are more than 15 mm.

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