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降结肠去分化脂肪肉瘤 1 例。

A case of dedifferentiated liposarcoma of the descending colon.

机构信息

Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan.

Department of Gastroenterology and Hepatology, Shiga General Hospital, 5-4-30 Moriyama, Moriyama, Shiga, 524-8524, Japan.

出版信息

Clin J Gastroenterol. 2023 Jun;16(3):361-365. doi: 10.1007/s12328-023-01762-5. Epub 2023 Feb 3.

Abstract

A 54-year-old man referred to our hospital for abdominal distension. He had no medical history. On physical examination, he complained lower abdominal distention, and had no spontaneous pain or tenderness. The blood tests showed that CEA and CA19-9 levels were within normal limits. Colonoscopy revealed a submucosal tumor with irregularities and mucosal defects in the descending colon. Computed tomography (CT) showed a 3-cm-diameter mass in the descending colon and ascites. Due to the presence of ascites, laparoscopic examination was performed, which revealed multiple peritoneal seeding of the tumor. Given the presence of peritoneal dissemination, the tumor was determined to be unresectable, and a histological examination was performed from the disseminated nodule. Pathologically, atypical spindle cells were observed and infiltrated into adipose tissue. Additional immunohistochemistry revealed positive expression for Murine double minute 2 (MDM2) and Cyclin-dependent kinase 4 (CDK4), and fluorescence in situ hybridization showed amplification of MDM2. Thus, the tumor was diagnosed with a dedifferentiated liposarcoma of the descending colon. Liposarcoma is a type of soft-tissue sarcoma that arises from soft tissues such as the extremities or retroperitoneum. Here, we report an extremely rare case of a dedifferentiated liposarcoma of the colon.

摘要

一位 54 岁男性因腹胀就诊于我院。他无既往病史。体格检查时,患者诉下腹胀,无自发性腹痛或压痛。血液检查显示癌胚抗原(CEA)和糖类抗原 19-9(CA19-9)水平正常。结肠镜检查发现降结肠黏膜下肿瘤,呈不规则状,伴有黏膜缺损。计算机断层扫描(CT)显示降结肠有一个 3cm 直径的肿块和腹水。由于存在腹水,进行了腹腔镜检查,发现肿瘤在多个腹膜上播种。由于存在腹膜播散,肿瘤被认为无法切除,并从播散结节中进行了组织学检查。病理上观察到非典型梭形细胞,并浸润到脂肪组织中。进一步的免疫组织化学显示鼠双微体 2(MDM2)和细胞周期蛋白依赖性激酶 4(CDK4)阳性表达,荧光原位杂交显示 MDM2 扩增。因此,该肿瘤被诊断为降结肠去分化脂肪肉瘤。脂肪肉瘤是一种起源于四肢或腹膜后等软组织的软组织肉瘤。在此,我们报告一例非常罕见的结肠去分化脂肪肉瘤病例。

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