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Colon adenocarcinoma with dome-like phenotype: characteristic endoscopic ultrasonography (EUS) findings

Authors :
Shiro Hayashi
Masashi Yamamoto
Hirotsugu Saiki
Katsumi Yamamoto
Shiro Adachi
Hisashi Kondo
Aisa Sakamoto
Takamichi Komori
Wataru Takagi
Shunji Morita
Yuriko Otake
Tsutomu Nishida
Kei Takahashi
Makiko Urabe
Masami Inada
Takahiro Amano
Sachiko Nakajima
Source :
Endoscopy International Open, Vol 03, Iss 04, Pp E359-E362 (2015), Endoscopy International Open
Publication Year :
2015
Publisher :
Georg Thieme Verlag KG, 2015.

Abstract

An 80-year-old man underwent colonoscopy for proctorrhagia. Conventional white-light imaging showed a superficially flat and elevated lesion that appeared to be a submucosal tumor of the sigmoid colon. Chromoendoscopy with Indigo Carmine showed that the margin of the tumor was covered with normal epithelium but that there was a slight depression on its surface. Magnification endoscopy with Crystal Violet staining revealed the amorphous surface structure of the depressed lesion, but the surrounding mucosa showed a normal pit pattern. Endoscopic ultrasonography demonstrated that a hypoechoic mass was located in the submucosal layer, and a biopsy specimen obtained from the surface of the lesion showed evidence of adenocarcinoma. We then performed sigmoidectomy on the patient. Immunohistochemically, the tumor cells were positive for two mismatch repair proteins (MLH1 and MSH2), but in situ hybridization revealed that the specimen was negative for the Epstein – Barr virus. We finally diagnosed the lesion as adenocarcinoma with a dome-like phenotype of the sigmoid colon.

Details

Language :
English
ISSN :
21969736 and 23643722
Issue :
04
Database :
OpenAIRE
Journal :
Endoscopy International Open
Accession number :
edsair.doi.dedup.....5d322ac821abf2d9364fcc4b64ebcb34