Okumura Taishi, Hotta Kinichi, Aizawa Daisuke, Imai Kenichiro, Ito Sayo, Takada Kazunori, Shimoda Tadakazu, Ono Hiroyuki
Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan.
Division of Pathology, Shizuoka Cancer Center, Shizuoka, Japan.
Clin J Gastroenterol. 2025 Feb;18(1):95-99. doi: 10.1007/s12328-024-02073-z. Epub 2025 Jan 6.
Anal canal cancer (ACC) is a rare yet noteworthy malignancy that is strongly associated with high-risk human papillomaviruses (HPVs). This case report highlights the diagnostic utility of endocytoscopy (EC) in distinguishing high-grade squamous intraepithelial lesions (HSILs) from low-grade lesions (LSILs) in a 57-year-old male presenting with hematochezia. Traditional magnifying endoscopy was inconclusive; however, EC provided detailed visualization of cellular and vascular changes, facilitating a diagnosis of HPV-associated HSIL or carcinoma in situ. Subsequent en bloc resection by endoscopic submucosal dissection was performed successfully, with no recurrence at the 6-month follow-up. This case underscores the value of EC in enhancing diagnostic accuracy for anal lesions, suggesting potential benefits for broader diagnostic applications.
肛管癌（ACC）是一种罕见但值得关注的恶性肿瘤，与高危型人乳头瘤病毒（HPV）密切相关。本病例报告强调了内镜细胞检查（EC）在一名便血的57岁男性患者中区分高级别鳞状上皮内病变（HSIL）与低级别病变（LSIL）的诊断效用。传统的放大内镜检查结果不明确；然而，EC提供了细胞和血管变化的详细可视化，有助于诊断HPV相关的HSIL或原位癌。随后通过内镜黏膜下剥离术成功进行了整块切除，6个月随访时无复发。该病例强调了EC在提高肛管病变诊断准确性方面的价值，提示其在更广泛诊断应用中的潜在益处。
