Department of Gastroenterology and Hepatology, Mie University Hospital, Japan.
Department of Gastroenterology, Kinan Hospital, Japan.
Intern Med. 2023 Jan 15;62(2):227-231. doi: 10.2169/internalmedicine.9594-22. Epub 2022 Jun 7.
A 74-year-old man with anemia underwent colonoscopy, which revealed a 4-mm polyp in the ascending colon. The polyp was subsequently diagnosed as an adenomatous lesion according to the narrow-band imaging (NBI) International Colorectal Endoscopic classification/Japan NBI Expert Team classification and resected via cold snare polypectomy (CSP). However, a pathological examination revealed a well-differentiated adenocarcinoma with a positive vertical margin. We performed additional endoscopic resection at the CSP scar area, revealing residual submucosal cancer with lymphatic involvement. The patient then underwent additional surgical resection. In such cases, additional endoscopic resection might be a treatment option.
一位 74 岁男性因贫血行结肠镜检查,发现升结肠有一个 4mm 的息肉。根据窄带成像(NBI)国际结直肠内镜分类/日本 NBI 专家小组分类,该息肉被诊断为腺瘤性病变,并通过冷圈套息肉切除术(CSP)切除。然而,病理检查显示为分化良好的腺癌,且垂直切缘阳性。我们在 CSP 瘢痕区域进行了额外的内镜切除,发现残留的黏膜下癌伴淋巴管浸润。随后,患者接受了进一步的手术切除。在这种情况下,额外的内镜切除可能是一种治疗选择。