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A case of a granular type of laterally spreading tumor similar to advanced cancer type 2


, : A case of a granular type of laterally spreading tumor similar to advanced cancer type 2. Nichidai Igaku Zasshi 59(6): 254-257, June

A 70-year-old woman visited our hospital as the result of a positive occult blood test in a colorectal check up. Barium enema and endoscopic examination revealed a flat-elevated lesion with a surrounding wall-like tumor in the transverse colon this appeared to be a granular type of laterally-spreading tumor (LST), similar to advanced type 2 colorectal cancer. Tubular pits were found upon magnifying endoscopic observation at the outer and inner portions of the LST. Adenocarcinoma in the mucosa alone was suspected in the LST. Furthermore, a IIc lesion was found at the oral side of the LST, where submucosal invasion of adenocarcinoma was suspected. Right hemicolectomy was performed. Histologic evaluation of the LST showed a well-differentiated adenocarcinoma in adenoma (m), and that of the IIc lesion showed a well-differentiated adenocarcinoma with submucosal invasion (sm1). Granular type LST with a mixed subtype was reported. We conclude that the clinical classification of LST and an accurate description of the pit pattern are valuable diagnostic tools in colorectal cancer.

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