Gasljevic Gorana, Boc Nina, Brecelj Erik, But Hadzic Jasna, Klancic Marko, Mlakar Jernej
Department of Pathology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Department of Radiology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Case Rep Gastroenterol. 2018 Oct 2;12(3):602-607. doi: 10.1159/000492811. eCollection 2018 Sep-Dec.
Endoscopic colorectal tattooing with carbon-based dyes is commonly employed in order to assist with later localization of the lesion. Although carbon is thought to be nontoxic, there usually is some inflammatory reaction with fibrosis and granuloma formation after tissue injection. The aim of this report is to alert to a possible underestimated, late consequence of colorectal carbon-based marker tattooing, namely pronounced fibrosis at the site of the injection that could lead to a blurring and misinterpretation of changes evaluated by radiological techniques. We describe a case of cT stage overestimation due to fibrosis of the rectal wall and perirectal fat, induced by carbon-based dye injection in a 66-year-old patient. In our case it was an overestimation of MR evaluation in the case of early invasive carcinoma. Although there have been some studies on tissue effect of carbon-based dyes, the possible scenario consequence of cancer stage overestimation due to fibrosis has not yet been described. Such a mistake could lead to inappropriate overtreatment. Clinicians must be aware of the possible consequences of dye injection and resultant overestimation of T stage of colorectal cancer. More histological studies concerning histological changes after carbon-based marker tattooing are needed to establish the extent of its significance.
使用碳基染料进行内镜下结肠直肠纹身通常用于辅助后续病变定位。尽管碳被认为是无毒的，但在组织注射后通常会出现一些伴有纤维化和肉芽肿形成的炎症反应。本报告的目的是提醒人们注意结肠直肠碳基标记纹身可能被低估的晚期后果，即在注射部位出现明显的纤维化，这可能导致放射学技术评估的变化出现模糊和误判。我们描述了一例66岁患者因碳基染料注射导致直肠壁和直肠周围脂肪纤维化而引起cT分期高估的病例。在我们的病例中，对于早期浸润性癌，是磁共振成像（MR）评估出现高估。尽管已经有一些关于碳基染料组织效应的研究，但因纤维化导致癌症分期高估的可能情况后果尚未见报道。这样的错误可能导致不适当的过度治疗。临床医生必须意识到染料注射的可能后果以及由此导致的结直肠癌T分期高估。需要更多关于碳基标记纹身术后组织学变化的组织学研究来确定其意义程度。
