抄録
A 67-year-old man was diagnosed by colonoscope to have superficial elevated type lesion at rectum. This lesion measuring about 15 mm in diameter, magnifying chromoendoscopy revealed a VI low irregularity Kudo's pit pattern system. Magnifying endoscopy with narrow band imaging revealed capillary pattern (CP) type IIIA. We diagnosed this lesion to adenocarcinoma invading until slight submucosal layer (SM1) , planed endoscopic submucosal dissection (ESD) . During maneuver, string blood vessel, fibrosis and retraction of proper muscle existed in submucosal layer. This findings shows that a carcinoma is invading submucosal layer around 1,000 μm. Pathological examination of the resected specimen revealed moderately differentiated tubular adenocarcinoma invading submucosal layer (1,100 μm, SM2) , with no vascular and lymphatic vessel involvement and budding Grade1. The surgical margin was negative for cancer (pHM0 pVM0) . This case report highlights the importance of this submucosal finding, it suggests that the cancer invade submucosal layer.
