Karaki Y, Tazawa K, Fumoto K, Kushibuchi T, Saitoh M, Sawataishi M, Saeki T, Munakata S, Fujimaki M, Bando T
2nd Dept. of Surgery, Toyama Med. & Pharma. Univ.
Gan No Rinsho. 1988 Feb;34(2):219-25.
A 69-year-old female, chiefly complaining of diarrhea, was admitted to the Toyama Medical & Pharmaceutical University Hospital. A barium enema and an endoscopic examination revealed a villous adenocarcinoma of the rectum. Computerized tomography disclosed multiple metastatic lesions in the liver. She underwent an amptatio recti and an intra-arterial cannulation of the common hepatic artery in order to administer anticancer agents. Gross findings of the resected specimen showed villous adenocarcinoma containing a small ulcerated lesion. Histologic findings of this lesion revealed a collision neoplasm containing both an adenocarcinoma and a carcinoid with no obvious transitional region between the two lesions. The type D carcinoid, determined according to Soga's histologic classification, showed positive argyrophil granules but no argentaffin granules in the cytoplasm. The electron-microscopic findings of the carcinoid revealed small electron-dense endocrine granules measuring about 150 approximately 300 nm in diameter. The woman died 4 months after this operation.
一名69岁女性，主要因腹泻入院，入住富山医科药科大学医院。钡剂灌肠和内镜检查显示为直肠绒毛状腺癌。计算机断层扫描显示肝脏有多处转移灶。她接受了直肠切除术和肝总动脉内插管以便给予抗癌药物。切除标本的大体检查结果显示为含有一个小溃疡病变的绒毛状腺癌。该病变的组织学检查结果显示为一种碰撞性肿瘤，同时含有腺癌和类癌，两个病变之间无明显过渡区域。根据索加的组织学分类确定为D型类癌，其细胞质中嗜银颗粒呈阳性，但亲银颗粒呈阴性。类癌的电子显微镜检查结果显示直径约150至300纳米的小电子致密内分泌颗粒。该女性在此次手术后4个月死亡。
