Allen D C, Hughes D F, Calvert C H
Dis Colon Rectum. 1986 Nov;29(11):760-5. doi: 10.1007/BF02555329.
Two cases of carcinoma in Crohn's disease of the colon are reported. One patient was a 30-year-old man who had asymptomatic Crohn's ileocolitis resulting in an acute presentation due to toxic dilatation of the colon. This was preceded by a short prodromal period of four weeks, characterized by intermittent diarrhea on the basis of a coloileal tumor fistula. A mucus-secreting adenocarcinoma was present in the sigmoid colon associated with both adjacent and one nearby focus of high-grade mucosal dysplasia. Pelvic wall and abdominal metastases were present, and the patient died two months later. The other patient was a 60-year-old woman who had a nine-year history of biopsy-proven Crohn's proctocolitis. A stricture of the sigmoid colon due to Crohn's disease also harbored an invasive adenocarcinoma. The carcinoma was not evident preoperatively or on initial gross pathologic examination. The presentation and pathology of large intestinal carcinoma in Crohn's colitis are discussed and illustrated.
本文报告了两例结肠克罗恩病伴发癌的病例。其中一例患者为30岁男性，患有无症状的克罗恩病性回结肠炎症，因结肠中毒性扩张而急性发作。在此之前有四周的短暂前驱期，其特征为基于结肠回肠肿瘤瘘管的间歇性腹泻。乙状结肠存在分泌黏液的腺癌，伴有相邻及附近一处高级别黏膜发育异常病灶。出现盆腔壁和腹部转移，患者两个月后死亡。另一例患者为60岁女性，有经活检证实的克罗恩病性直肠结肠炎九年病史。因克罗恩病导致的乙状结肠狭窄也伴有浸润性腺癌。该癌在术前或最初的大体病理检查中均不明显。文中对克罗恩病性结肠炎中大肠癌的临床表现和病理进行了讨论并举例说明。
