Quinn Paul, Platell Cameron F E
University Department of Surgery, Fremantle Hospital, Fremantle, Western Australia, Australia.
Dis Colon Rectum. 2004 Mar;47(3):387-91. doi: 10.1007/s10350-003-0057-y.
Ulcerative colitis is known to predispose to the development of neoplasia, especially adenocarcinoma. Microcarcinoids represent small nests of gut endocrine cells located in the mucosa and submucosa of the bowel. Such lesions have been identified in association with chronic inflammation and the concern is that they may represent a precursor lesion for invasive carcinoid tumors. Yet carcinoid tumors are rarely reported in patients with ulcerative colitis. This case report documents a 56-year-old male with ulcerative colitis who was found on random biopsies to have microcarcinoids in his rectal submucosa. Following treatment of his colitis, there was complete resolution of both the inflammation and the microcarcinoids. However, on subsequent follow-up at six months, the patient's colitis has returned and so have the microcarcinoids. We explore the issue of whether these lesions represent true neoplasias that should be resected, or whether they represent cellular hyperplasia in response to the inflammatory stimulus.
已知溃疡性结肠炎易引发肿瘤，尤其是腺癌。微小类癌是位于肠道黏膜和黏膜下层的小群肠道内分泌细胞。此类病变已被证实与慢性炎症相关，人们担心它们可能是侵袭性类癌肿瘤的前驱病变。然而，溃疡性结肠炎患者中类癌肿瘤的报道很少。本病例报告记录了一名56岁患有溃疡性结肠炎的男性，在随机活检中发现其直肠黏膜下层有微小类癌。在治疗其结肠炎后，炎症和微小类癌均完全消退。然而，在随后6个月的随访中，患者的结肠炎复发，微小类癌也再次出现。我们探讨了这些病变是代表应切除的真正肿瘤，还是代表对炎症刺激的细胞增生这一问题。
