Di Prete Monia, Baciorri Francesca, Franceschilli Marzia, Bagaglini Giulia, Sica Giuseppe, Doldo Elena, Palmieri Giampiero, Orlandi Augusto
Anatomic Pathology, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy.
Surgery, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy.
Clin J Gastroenterol. 2020 Aug;13(4):555-559. doi: 10.1007/s12328-020-01101-y. Epub 2020 Feb 5.
Colorectal carcinoma is one of the most frequent human malignant neoplasms. Besides the most common histological types, colorectal adenosquamous carcinoma is very rare, being microscopically constituted by tumoural glandular and squamous components. The diagnosis of primary colon adenosquamous carcinoma requires the exclusion of a metastatic squamous cell carcinoma and the extension of a primary squamous cell carcinoma from the anal-rectum junction. We report a case of primary adenosquamous carcinoma of the ascending colon in a 62-year-old Caucasian man affected by long-standing ulcerative colitis. Peritumoural lymph nodes and distant metastasis were present. We reported also a diffuse signet-ring mucinous component, which has not been previously observed. Moreover, we investigated microsatellite and all-RAS/B-RAF status, p16 and p53 protein expression, and the molecular presence of human papillomavirus DNA in all the morphologically distinct components, in order to suggest pathogenetic factors influencing the aggressive prognosis of colon adenosquamous carcinoma.
结直肠癌是人类最常见的恶性肿瘤之一。除了最常见的组织学类型外，结直肠腺鳞癌非常罕见，在显微镜下由肿瘤性腺性和鳞状成分构成。原发性结肠腺鳞癌的诊断需要排除转移性鳞状细胞癌以及原发性鳞状细胞癌从肛管直肠交界处的扩展。我们报告了一例62岁患有长期溃疡性结肠炎的白种男性升结肠原发性腺鳞癌病例。存在肿瘤周围淋巴结和远处转移。我们还报告了一种弥漫性印戒黏液成分，此前尚未观察到。此外，我们研究了微卫星和全RAS/B-RAF状态、p16和p53蛋白表达以及人乳头瘤病毒DNA在所有形态学上不同成分中的分子存在情况，以提示影响结肠腺鳞癌侵袭性预后的致病因素。
