Nakamura Hajime, Takanashi Kunihiro, Morita Rie, Hirata Yuya, Kanari Yusuke, Komatsu Yuya, Noda Ai, Ueki Tomomi, Hirohashi Yoshihiko, Katsuki Shinichi
Center of Gastroenterology, Otaru Ekisaikai Hospital.
Department of Pathology, Sapporo Medical University School of Medicine.
Nihon Shokakibyo Gakkai Zasshi. 2021;118(10):943-951. doi: 10.11405/nisshoshi.118.943.
A 72-year-old man was diagnosed with tumors outside of the stomach and mesentery of the small intestine on abdominal computed tomography. Histopathological examination of an endoscopic ultrasound-guided fine-needle aspiration biopsy specimen confirmed the diagnosis of lymph node metastasis of a neuroendocrine tumor (NET). Gastroscopy, colonoscopy, small bowel capsule endoscopy, somatostatin receptor scintigraphy, and 18F-fluorodeoxyglucose positron emission tomography were performed. However, the primary lesion could not be diagnosed. The patient underwent surgery, and an ileal submucosal tumor, which was not identified preoperatively in addition to the aforementioned abdominal tumors, was detected. All tumors were diagnosed as NET, and the ileal tumor was considered the primary lesion. The patient has shown no recurrence postoperatively. The current study presents a case of an ileal NET with lymph node metastases in a patient in whom the primary lesion remained preoperatively undiagnosed.
一名72岁男性经腹部计算机断层扫描诊断为胃外和小肠系膜肿瘤。内镜超声引导下细针穿刺活检标本的组织病理学检查确诊为神经内分泌肿瘤(NET)淋巴结转移。进行了胃镜、结肠镜、小肠胶囊内镜、生长抑素受体闪烁显像和18F-氟脱氧葡萄糖正电子发射断层扫描。然而,原发灶无法确诊。患者接受了手术,术中除上述腹部肿瘤外,还发现了术前未识别的回肠黏膜下肿瘤。所有肿瘤均诊断为NET,回肠肿瘤被认为是原发灶。患者术后未出现复发。本研究报告了一例回肠NET伴淋巴结转移的病例,该患者术前原发灶未被诊断。