Department of Surgery, Kushiro Red Cross Hospital, 21-14 Shinei-cho, Kushiro, Hokkaido, 085-8512, Japan.
Surg Today. 2011 Sep;41(9):1284-9. doi: 10.1007/s00595-010-4474-y. Epub 2011 Aug 26.
We report an unusual case of goblet cell carcinoid (GCC) of the rectum. A 75-year-old man was admitted to our hospital with anal bleeding, and a hard tumor was felt on the anterior wall of the lower rectum during rectal examination. We performed colonoscopy, and found a 30-mm type 2 tumor in the lower rectum and anal canal. Histological examination of biopsies revealed rectal adenocarcinoma. Based on these findings, we diagnosed rectal adenocarcinoma and performed Miles' operation with lymph node dissection. Histological examination revealed an invasive lesion composed of signet-ring-like cells. Seven regional lymph node metastases were seen microscopically. The tumor produced copious mucin, which was stained with Alcian blue. Immunohistochemistry was positive for synaptophysin, chromogranin A, CD56, carcinoembryonic antigen, p53, Ki-67, E-cadherin, and cytokeratin 20. The final diagnosis was GCC of the rectum.
我们报告一例直肠类癌的不典型病例。一名 75 岁男性因肛门出血而入院，直肠检查时在前壁下段直肠可触及坚硬的肿瘤。我们进行了结肠镜检查，发现下段直肠和肛管有一个 30mm 的 2 型肿瘤。活检的组织学检查显示直肠腺癌。基于这些发现，我们诊断为直肠腺癌，并进行 Miles 手术加淋巴结清扫术。组织学检查显示一种由印戒样细胞组成的浸润性病变。显微镜下可见 7 个区域淋巴结转移。肿瘤产生大量粘蛋白，用阿尔辛蓝染色。免疫组织化学检查突触素、嗜铬粒蛋白 A、CD56、癌胚抗原、p53、Ki-67、E-钙黏蛋白和细胞角蛋白 20 阳性。最终诊断为直肠类癌。
