Miyahara M, Saito T, Etoh K, Shimoda K, Kitano S, Kobayashi M, Yokoyama S
Department of Surgery I, Oita Medical University, Japan.
Surg Today. 1995;25(9):834-7. doi: 10.1007/BF00311463.
A 40-year-old woman with Peutz-Jeghers syndrome and an appendiceal intussusception is reported. In this patient, the lead point was a large sessile, appendiceal polyp. The invaginated and inverted portion of the appendix resembled the long stalk of a pedunculated polyp on roentgenography and endoscopic examination. Histologically, the appendiceal polyp was a villous adenoma with mild to severe atypia and focal carcinoma in situ. In patients with Peutz-Jeghers syndrome, hamartomatous polyps and colorectal adenomatous polyps with highly malignant potential can coexist and must be managed appropriately. Therefore, when evaluating a polypoid or a pedunculated lesion in the cecal lumen, the possibility of an appendiceal intussusception should also be investigated.
本文报道了一名患有黑斑息肉综合征并伴有阑尾套叠的40岁女性。在该患者中,套叠的起始点是一个大的无蒂阑尾息肉。在X线造影和内镜检查中,阑尾内陷和翻转的部分类似于有蒂息肉的长蒂。组织学上,阑尾息肉是一个具有轻至重度异型性和局灶原位癌的绒毛状腺瘤。在黑斑息肉综合征患者中,错构瘤性息肉和具有高度恶性潜能的结直肠腺瘤性息肉可能并存,必须进行适当处理。因此,在评估盲肠腔内的息肉样或有蒂病变时,也应调查阑尾套叠的可能性。