Hanzel Jurij, Ranković Branislava, Ribnikar Marija
Gastroenterology, University Medical Centre Ljubljana, Ljubljana, SVN.
Pathology, University of Ljubljana, Ljubljana, SVN.
Cureus. 2020 Jun 3;12(6):e8420. doi: 10.7759/cureus.8420.
Metastases to the colon are rare and may mimic other diseases such as inflammatory bowel disease. This differential diagnosis is often overlooked by endoscopists which leads to unnecessary diagnostic delay or inappropriate treatment. We present a case of a 54-year-old woman who presented with ascites. Malignant cells were demonstrated on cytologic examination of ascitic fluid, but no primary tumour or metastases were seen on computed tomography of the abdomen. On colonoscopy, an impassable stenosis was found in the transverse colon with scattered patches of oedematous colonic mucosa through to the mid-descending colon. Histological examination revealed scattered signet ring cells and the diagnosis of gastric signet ring cell adenocarcinoma was confirmed with subsequent gastroscopy. The correct and timely diagnosis of metastatic lesions to the colon requires a high index of suspicion and adequate mucosal sampling with multiple biopsies.
结肠转移瘤罕见，可能会与其他疾病如炎症性肠病相混淆。内镜医师常常忽略这种鉴别诊断，从而导致不必要的诊断延迟或不恰当的治疗。我们报告一例54岁女性，她表现为腹水。腹水细胞学检查发现恶性细胞，但腹部计算机断层扫描未发现原发性肿瘤或转移灶。结肠镜检查发现横结肠有无法通过的狭窄，散在的水肿性结肠黏膜斑一直延伸至降结肠中部。组织学检查发现散在印戒细胞，随后的胃镜检查确诊为胃印戒细胞腺癌。对结肠转移瘤进行正确及时的诊断需要高度的怀疑指数和通过多次活检进行充分的黏膜采样。
