Abstract
The authors studied macroscopic features of colectomized specimens and preoperative endoscopic appearance associated with early cancer and/or dysplasia in 4 cases with long-standing colitis. The cases consisted of 2 patients with ulcerative colitis, 1 with intestinal tuberculosis and 1 with Crohn's disease. There were 4 early cancers (3 mucosal and 1 submucosal cancer), 1 advanced cancer and 6 dysplastic lesions in the colectomized specimens. Macroscopic appearance of 3 mucosal cancers was flat (two lesions) and slightly depressed (one lesion). Submucosal cancer was a sessile polypoid mass. Of 6 dysplasitic lesions, 4 were even mucosa, 1 was granular mucosa and 3 were slightly elevated lesions. Dysplastic lesions tended to be lower in height than early cancers. Colonoscopic diagnosis could be made for flat tumors and some dysplastic lesions such as even mucosa accompanied with redness or granular mucosa. These fine lesions appeared more clearly using color corrector treatment of videoscopic image and dyecontrast method with indigocarmine. Early colitic cancer is characterized by the flat tumor surrounded by even red mucosa or granular mucosa which is different from healed mucosa.
