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비전형적 대장 선암:방사선학적-병리학적 연관
Atypical Adenocarcinoma of the Colon : Radiologic-Pathologic Correlation

김영찬    (경희대학교 의과대학 해부병리과학교실  );
  • 초록

    Purpose : To analyse unusual radiologic manifestations of colonic adenocarcinoma, and to correlate these with pathologic findings. Materials and Methods : Radiologic findings of ten patients with atypical adenocarcinoma of the colon were retrospectively evaluated. The unusual radiologic findings were defined as terminal ileal involvement of the cecal mass, long segmental involvement of over 9cm, and exophytic tumor growth. radiologic and sonographic findings were compared with pathologic specimens obtained from surgical resection. Results :Involvement of the terminal ileum was noted in three cases, long segmental involvement of over 11cm in five cases, and exophytic mass in two. Of three cases with thickening of the terminal ileum, two revealed the infiltration of cancer into the terminal ileum through the ileocecal valve, and the other revealed vascular congestion and edemaon microscopic examination. Five cases with long segmental involvement of over 11cm comprised one of cancertotally infiltrated through the submucosal and proper muscle layer, one of inflammatory thickening distal to the cancer, two of inflammatory change of pericolic fat and serosal adhesion and one of a large intraluminal fungatingmass. In the cases of exophytic mass, one with a larger extraluminal and a smaller intraluminal component revealednecrosis and abscess on pathologic examination, accounting for low attenuation on CT, whereas the other, with exophytic growth, disclosed abundant pools of mucin, resulting in low attenuation on CT. These two cases could not be differentiated from submucosal tumors. Conclusion : Atypical colon cancer may have various manifestations, such as thickening of the terminal ileum, involvement of a long segment, and an exophytically growing mass. Anappreciation of the radiologic findings of this cancer may therefore help in differential diagnosis in casessimulating colitis or submucosal tumors of the colon, such as lymphoma or leiomyoma.


  • 주제어

    Colon, neoplasms .   Colon, radiography.  

  • 참고문헌 (11)

    1. 대장암의 방사선학적 및 임상적 고찰 , 신옥자;진수일;이관세;박수성 , 대한방사선의학회지 / v.18,pp.316-324,
         
    2. Margulis AR;Burhenne HJ , Alimentary tract radiology. (3th ed) / v.,pp.1056-1063,
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    5. Ileal lymphatic metastases from cecal carcinoma , Moffat RE;Gourly WK , Radiology / v.135,pp.55-58,
    6. Neoplasia of the colon over a long segment , Greenbaum EI;Freedman S , Clin Radiol / v.24,pp.416-426,
    7. Roentgen features of diffuse lymphosarcoma of the colon , Wolf BS;Marshak RH , Radiology / v.75,pp.733-740,
    8. Eisenberg RL , Gastrointestinal radiology. (3rd ed) / v.,pp.560,
    9. Gore RM;Levine MS;Laufer I , Textbook of gastrointestinal radiology. (1st ed) / v.,pp.1201,
    10. Colon and rectal carcinoma : spatial distribution and detection , Maglinte DDT;Keller KJ;Miller RE;Chernish SM , Radiology / v.147,pp.669-672,
    11. Freeny DC;Stevenson GW , Margulis and Burhenne's alimentarty tract radiology. (5th ed) / v.,pp.790-793,
  • 이 논문을 인용한 문헌 (1)

    1. 1997. "Mucinous Adenocarcinoma of Ascending Colon Associated with Inflammatory Disease : 2 Case reports" 대한방사선의학회지 = Journal of the Korean Radiological Society, 37(5): 877~880     

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  • 김영찬 (4)

    1. 1995 "동문맥 단락을 동반한 간혈관종:1예 보고" 대한방사선의학회지 = Journal of the Korean Radiological Society 33 (2): 285~287    
    2. 1997 "재발성 화농성 담관염의 혈관 조영술 소견과 그 의의" 대한방사선의학회지 = Journal of the Korean Radiological Society 37 (1): 109~113    
    3. 1997 "경화제로서의 Acetic Acid의 유용성에 대한 실험적 연구" 대한방사선의학회지 = Journal of the Korean Radiological Society 37 (2): 233~236    
    4. 1998 "뇌하수체 선종의 감마나이프 수술후 자기공명영상 소견의 변화 : 임상소견과의 비교연구" 대한방사선의학회지 = Journal of the Korean Radiological Society 38 (6): 979~983    

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