Muratsu Arisa, Noura Shingo, Matsumura Tae, Hirota Masaki, Yasuyama Harunobu, Koga Chikato, Takata Akihiro, Kameda Chizu, Murakami Masahiro, Kawabata Ryohei, Shimizu Junzo, Miwa Hideaki, Hasegawa Junichi
Dept. of Surgery, Osaka Rosai Hospital.
Gan To Kagaku Ryoho. 2017 Nov;44(12):1814-1816.
A 76-year-old woman with bloody stool visited a nearby hospital. Colonoscopy showed a type 1 tumor in the rectum, and the biopsy indicated moderately differentiated adenocarcinoma. She was referred to our hospital. Abdominal contrast-enhanced CT did not show swollen lymph nodes in the regional nodes or distant metastases. Laparoscopic lower anterior resection was performed. Histopathological examination indicated pT1b, pN3, ly3, and v1, fStage III b, which had a partial invasive micropapillary carcinoma(IMPC)component of papillary adenocarcinoma. Although she received postoperative adjuvant chemotherapy, she died of a thromboembolism with paraneoplastic syndrome 20 months after the operation. IMPC has a high incidence of lymphatic invasion and lymph node metastases. IMPC is rare in cases of colorectal cancer and it is important to accumulate and investigate colorectal cancer patients with IMPC.
一名76岁便血女性前往附近医院就诊。结肠镜检查显示直肠有1型肿瘤，活检提示为中分化腺癌。她被转诊至我院。腹部增强CT未显示区域淋巴结肿大或远处转移。遂行腹腔镜低位前切除术。组织病理学检查显示为pT1b、pN3、ly3和v1，f分期为III b期，其中乳头腺癌有部分浸润性微乳头癌（IMPC）成分。尽管她接受了术后辅助化疗，但术后20个月死于血栓栓塞伴副肿瘤综合征。IMPC的淋巴侵犯和淋巴结转移发生率较高。IMPC在结直肠癌病例中较为罕见，积累和研究患有IMPC的结直肠癌患者很重要。
