2019 Volume 44 Issue 5 Pages 960-965
We encountered a rare case of early transverse colon cancer and an enlarged para-aortic lymph node in a 69-year-old male patient. Colonoscopy revealed a stage 0–Ⅱa tumor at the transverse colon, and the tumor was resected with endoscopic submucosal dissection. Histopathologic findings revealed that the tumor was an adenocarcinoma and that the vertical margin was positive. Abdominal computed tomography (CT) revealed an enlarged para-aortic lymph node (#216), and positron emission tomography/CT revealed intense tracer uptake at the same lymph node (maximum standardized uptake value, 7.4). A diagnosis of transverse colon adenocarcinoma with #216 lymph node metastasis or a collision tumor (malignant lymphoma) was established. A laparoscopic transverse colectomy with D2 lymph node dissection and extraction of the #216 lymph node were performed. Histopathologic findings revealed that the transverse colon adenocarcinoma was T1bN0M0, pStage I, and that the resected para-aortic lymph node had grade 1-2 follicular lymphoma. To decide the treatment policy, it is important to perform a biopsy positively.
