抄録
We describe a case of sporadic cancer in a patient with Ulcerative Colitis in which detailed endoscopic examination did not show any signs of advanced neoplasia.
This was a 50-year-old women that presented for surveillance colonoscopy. During colonoscopy under white light examination a flat (Paris 0-IIa) 10mm rectal lesion was detected. With magnifying endoscopy with narrow band imaging (M-NBI) , we recognized regular vessels as described with the Showa classification. Magnifying chromoendoscopy reveled type IIIL and type-IV were the dominant pit patterns. On endocytoscopy examination EC3a classification was seen indicating intramucosal carcinoma. The lesion was resected with EMR. A pathological diagnosis was well differentiated tubular adenocarcinoma (tub1) , pTis (M) , ly0, v0. Histologically, the lesion was growing down from the surface epithelium (top-down type) , which is not typical of dysplasia associated cancers.
