Fujii Yasutomo, Taniguchi Nobuyuki, Ono Tomoko, Omoto Kiyoka, Itoh Kouichi, Shitoh Kazuhisa, Okada Masaki, Yasuda Yoshikazu, Nagai Hideo
Department of Clinical Laboratory Medicine, Jichi Medical School, Minami Kawachi-machi, Kawachi-gun, Tochigi 329-0498, Japan.
J Clin Ultrasound. 2003 Nov-Dec;31(9):488-92. doi: 10.1002/jcu.10204.
We describe the case of a 75-year-old woman with linitis plastica carcinoma of the colon, accompanied by a peritoneal abscess, in which the use of transabdominal sonography enabled prompt detection and diagnosis. Sonographic examinations revealed diffuse wall thickening with blurred layer stratification in the ascending colon. The irregular outer margin of the affected area was surrounded by thickened pericolic fat. A peritoneal abscess covered by the omentum was also found. CT confirmed these findings. We extensively resected the right half of the colon. Histopathologic examination of the excised segment of the colon revealed a poorly differentiated adenocarcinoma with fibrotic infiltration. The patient was discharged 6 weeks postoperatively, and chemotherapy was begun, but she was lost to our follow-up. Although linitis plastica carcinoma of the colon is rare, it must be considered when patients have extensive colonic wall thickening with blurred layer stratification and an irregular outer margin surrounded by thickened pericolic fat. Transabdominal sonography should be considered the imaging modality of choice for the detection and diagnosis of this disease entity.
我们描述了一例75岁患有结肠皮革胃样癌并伴有腹膜脓肿的女性病例,经腹超声检查实现了对此病的快速检测与诊断。超声检查显示升结肠壁弥漫性增厚,层次结构模糊。病变区域不规则的外缘被增厚的结肠周围脂肪包绕。还发现了一处被大网膜覆盖的腹膜脓肿。CT证实了这些发现。我们对结肠右半部分进行了广泛切除。对切除的结肠段进行组织病理学检查显示为低分化腺癌伴纤维化浸润。患者术后6周出院并开始化疗,但失访。尽管结肠皮革胃样癌罕见,但当患者出现广泛的结肠壁增厚、层次结构模糊且外缘不规则并被增厚的结肠周围脂肪包绕时,必须考虑到该病。经腹超声应被视为检测和诊断这种疾病实体的首选成像方式。