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Endoscopic and histopathological study of diminutive carcinomas 5mm or less in diameter of the large bowel

Endoscopic and histopathological study of diminutive carcinomas 5mm or less in diameter of the large bowel

Stomach & Intestine (Tokyo) 22(4): 465-472

Nine diminutive early carcinomas (0.35%) out of 2,540 colonic polyps were identified and removed endoscopically during the past four year and two months. Three of these were located in the sigmoid colon, two each in the rectum and the ascending colon, and one each in the transverse colon and the cecum. Four cases (44.4%) were accompanied by other elevated lesions including focal carcinomas in two cases. All lesions were classified into protruded type. In four cases were discoloration, capillary dilatation, bleeding and significant hardness observed endoscopically on the polypoid lesion. An irregular ulceration with white coat suggestive of malignancy was noted on the top of the lesion in only one case. The rest of the cases did not appear malignant endoscopically, but were shown later to have carcinoma by histological examination. Histopathology showed well differentiated adenocarcinoma in all cases; carcinoma in adenoma in four cases; adenoma in carcinoma in three cases; carcinoma de novo in two cases. Carcinomatous invasion was limited to the mucosal layer in eight cases (88.9%) and seen massively in the submucosa in one case. There was neither lymphatic nor venous infiltration in any cases. In conclusion, even in cases of diminutive polyps (5 mm or less in diameter) carcinomas were recognized endoscopically. Furthermore, both carcinomas accompanied by adenoma and carcinomas de novo were shown to exist.

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Accession: 005359099

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