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[一例以粪便潜血为表现的回肠神经内分泌肿瘤]

[A Case of Neuroendocrine Tumor of the Ileum Manifesting as Fecal Occult Blood].

作者信息

Mori Ryota, Naito Atsushi, Kato Takeshi, Nose Yohei, Oneda Yasuo, Ishida Tomo, Kuwahara Ryuichi, Akiyama Yasuki, Murakami Kohei, Katsura Yoshiteru, Kagawa Yoshinori, Ohmura Yoshiaki, Takeno Atsushi, Takeda Yutaka, Tamura Sigeyuki

机构信息

Dept. of Surgery, Kansai Rosai Hospital.

出版信息

Gan To Kagaku Ryoho. 2016 Nov;43(12):1854-1856.

Abstract

A 42-year-old woman was admitted to our hospital because of a positive fecal occult blood test. Colonoscopy examination revealed an elevated lesion measuring 25mm in diameter at the terminal ileum. A histological diagnosis of neuroendocrine tumor(NET)was made based on biopsy specimens taken from the lesion. Since no apparent distant metastasis other than the ileocolic lymph nodes was noted, laparoscopy-assisted ileocecal resection with regional lymph node dissection was performed. In the resected material, NET(G2)limited to the subserosa layer was present. The NET tested positive for synaptophysin, chromogranin A, and CD56. Metastases in the paraileal lymph nodes was detected. NET metastasis to the ileum is frequent, even if the tumor is small in diameter; therefore, it is necessary to resect the tumor entirely and to dissect the regional lymph nodes.

摘要

一名42岁女性因粪便潜血试验阳性入住我院。结肠镜检查发现回肠末端有一个直径25mm的隆起性病变。根据从病变处获取的活检标本作出神经内分泌肿瘤(NET)的组织学诊断。由于除回结肠淋巴结外未发现明显的远处转移,遂行腹腔镜辅助回盲部切除术及区域淋巴结清扫术。在切除的标本中,NET(G2)局限于浆膜下层。该NET突触素、嗜铬粒蛋白A和CD56检测呈阳性。检测到回肠旁淋巴结有转移。即使肿瘤直径较小,NET转移至回肠也很常见;因此,有必要完整切除肿瘤并清扫区域淋巴结。

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