Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongtinan Lu, Chaoyang District, Beijing 100020, China.
Clin Res Hepatol Gastroenterol. 2012 Aug;36(4):e63-8. doi: 10.1016/j.clinre.2011.12.013. Epub 2012 Feb 9.
A 38-year-old Chinese man presenting with chronic diarrhea and secondary incomplete intestinal obstruction was hospitalized in April 2010. Electronic colonoscopy and barium enema examination initially showed longitudinal scar-like strictures and cobblestone appearance in the colon that was similar to those in Crohn's disease. After subtotal colectomy and partial intestinal resection, the pathological examination indicated colon adenocarcinoma that diffusely infiltrated along the colon longitudinal axis rather than the initial diagnosis of Crohn's disease. Pathological examination revealed colon adenocarcinoma with excessive desmoplastic reaction and infiltrating cancer cells along the colon longitudinal axis that may have accounted for the morphological similarities to Crohn's disease in this case. The findings in the present case suggest that colon carcinoma should be considered when Crohn's disease-like findings are encountered, not only in individuals with concurrent cancer in other sites, but also in patients with a long history of gastrointestinal symptoms such as chronic diarrhea or abdominal pain.
一位 38 岁的中国男性，因慢性腹泻和继发性不完全肠梗阻于 2010 年 4 月住院。电子结肠镜和钡灌肠检查最初显示结肠呈纵向瘢痕样狭窄和鹅卵石外观，类似于克罗恩病。行结肠次全切除和部分肠切除术后，病理检查提示为弥漫浸润性结肠腺癌，而不是最初的克罗恩病诊断。病理检查显示，结肠腺癌有过度的纤维组织反应和浸润性癌细胞沿结肠纵轴浸润，这可能是导致该病例与克罗恩病形态相似的原因。本病例提示，当遇到类似克罗恩病的表现时，不仅应考虑合并其他部位癌症的患者，还应考虑有慢性腹泻或腹痛等胃肠道症状病史较长的患者，结肠腺癌的可能性。
