Sonoda Hirofumi, Kawai Kazushige, Yamaguchi Hironori, Murono Koji, Kaneko Manabu, Nishikawa Takeshi, Otani Kensuke, Sasaki Kazuhito, Yasuda Koji, Tanaka Toshiaki, Kiyomatsu Tomomichi, Hata Keisuke, Nozawa Hiroaki, Ishihara Soichiro, Aikou Susumu, Yamashita Hiroharu, Ushiku Tetsuo, Seto Yasuyuki, Fukayama Masashi, Watanabe Toshiaki
Department of Surgical Oncology, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, 113-8655 Tokyo, Japan.
Department of Surgical Oncology, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, 113-8655 Tokyo, Japan.
Clin Res Hepatol Gastroenterol. 2017 Dec;41(6):e81-e86. doi: 10.1016/j.clinre.2017.04.002. Epub 2017 May 16.
Metastases to the colon are rare and a high-frequency primary region is the stomach. In cases of metastases to the colon, the morphological type of the metastatic region is mostly the infiltrating type of poorly differentiated or undifferentiated adenocarcinoma with lymph and blood vessel invasion. A case of cancer metastasis to the transverse colon that originated from advanced gastric cancer, which shows the difficulties in the precise diagnosis of metastases to the colon, is presented. In the present case, the gastric carcinoma was determined to be an advanced infiltrative ulcerative adenocarcinoma and the colon carcinoma was determined to be a superficial depressed adenocarcinoma. After surgery, the colon carcinoma was diagnosed as a metastatic adenocarcinoma from gastric adenocarcinoma with high invasion of vessels, by immunohistopathological analysis of CK7, CK20, p53 and HER-2. In this report, previously reported cases of metastases to the colon from gastric cancer were reviewed and their morphological characteristics were analyzed.
结肠癌转移罕见,高频原发部位是胃。在结肠癌转移病例中,转移区域的形态学类型多为伴有淋巴和血管侵犯的低分化或未分化腺癌浸润型。本文报告1例源自进展期胃癌的横结肠癌转移病例,该病例显示了结肠癌转移精确诊断的困难。在本病例中,胃癌被判定为进展期浸润性溃疡性腺癌,结肠癌被判定为浅表凹陷性腺癌。术后,通过对CK7、CK20、p53和HER-2进行免疫组织病理学分析,结肠癌被诊断为源自胃腺癌的转移性腺癌,血管侵犯程度高。在本报告中,回顾了既往报道的胃癌转移至结肠的病例,并分析了其形态学特征。