Nakayama H, Akikusa B, Kondo Y, Saito N, Sarashina H, Okui K
Department of Pathology, School of Medicine, Chiba University, Japan.
Dis Colon Rectum. 1989 Mar;32(3):243-6. doi: 10.1007/BF02554538.
A rare case of mucinous cystadenocarcinoma arising in the sigmoid colon, found accidentally during an operation for cholecystolithiasis, is reported. The tumor was located 40 cm from the anal verge, and had two histologic variations consisting of a large distended cystic lesion and branching cystic channels with papillary proliferation of the epithelium. Serial sections revealed the existence of a luminal communication between the two lesions. The tumor tissue was seen mainly in the muscularis propria with no mucosal involvement. The papillary portion had a highly differentiated appearance, giving rise to considerable difficulty in determining whether it was benign or malignant. In a localized area, however, the tumor invaded into the subserosa and showed distinctive atypical changes. The tumor cells showed intense reactivity for carcinoembryonic antigen. This mucinous cystadenocarcinoma was considered to be originated from an enterogenous cyst, a possible derivative of duplication of the colon. The differential diagnosis concerning this rare tumor is also discussed.
报告了一例罕见的乙状结肠黏液性囊腺癌，该病例在胆囊结石手术中意外发现。肿瘤位于距肛缘40cm处，有两种组织学变异，包括一个大的扩张性囊性病变和带有上皮乳头样增生的分支状囊性管道。连续切片显示两个病变之间存在管腔连通。肿瘤组织主要见于固有肌层，未累及黏膜。乳头部分外观高度分化，难以确定其是良性还是恶性。然而，在局部区域，肿瘤侵犯至浆膜下层并表现出明显的非典型改变。肿瘤细胞对癌胚抗原有强烈反应。该黏液性囊腺癌被认为起源于肠源性囊肿，可能是结肠重复畸形的衍生物。文中还讨论了关于这种罕见肿瘤的鉴别诊断。
